Support for the statewide broadcast of the state of Ohio comes from medical mutuel, providing more than 1.4 million Ohioans peace of mind with a selection of health insurance plans online at med mutual dot com slash Ohio by the law offices of Porter Wright, Morris and Arthur LLP.

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More at Porter Wright dot com and from the Ohio Education Association representing 124,000 members who work to inspire their students to think creatively and experience the joy of learning online.

At OHEA.org Early voting continues for most races, but a later date for a legislative primary isn't set.

The Ohio Supreme Court wades into streaming services and whether they owe money to cities like cable companies do.

And health care coverage will continue for millions who are on Medicaid during the pandemic.

But the state is preparing for hundreds of thousands to be enrolled when the public health emergency ends.

That's all this week in the state of Ohio.

Welcome to the state of Ohio.

I'm Karen Kasler.

Early voting for the May primary is in its second week and it's going slowly, which is expected for a midterm primary.

Since turnout for midterm primaries in Ohio since 1986 has averaged about 28%.

As of Tuesday, 71,296 absentee ballots have been requested by mail or in-person 11,935 votes have been cast statewide.

That's about 40% off the requested and return to cast ballots from 2018.

There have been more Republican ballots taken out than Democratic ones which isn't surprising given the hotly contested Republican U.S. Senate race.

And there are contested primaries among Republicans running for governor and secretary of state.

There are also competitive races among Democrats running for governor and U.S. Senate.

But there aren't House and Senate races on that May primary ballot.

And there's still no sign of when the primary for those candidates will happen.

On Thursday, the Ohio Supreme Court again split four to three and ruled a fourth set of legislative maps unconstitutional.

The court said the Ohio Redistricting Commission, quote, has a head start toward a complete and possibly constitutionally compliant plan and should continue to work with independent map draws to get new maps approved by May 6th.

But the ballot does include congressional primaries, though that 15 district map is still under review.

A group of Youngstown voters say they will file a request not to certify the winners of the congressional primary with the Northern District of Ohio.

After three federal judges in the Southern District suggested that the voters said the map was drawn without racial considerations in violation of the Voting Rights Act.

But the judges said the request exceeded the scope of the original case.

The voters are intervenors in a lawsuit filed by some Republican voters who want the federal court to implement state legislative district maps that have been found unconstitutional by the Ohio Supreme Court, No decision on that lawsuit is likely until after April 20th.

The U.S. Supreme Court is considering whether Netflix and Hulu should be covered by a 2007 state law that requires cable companies to pay franchise fees to cities.

The question comes from a class action lawsuit filed by 2000 cities against the streaming services and a decision in the case could have national implications.

The cities claim Netflix and Hulu should be authorized as video service providers by the Ohio Department of Commerce and pay franchise fees that amount to 5% of the gross revenue they get from each city.

Justin Howell with the city of Maple Heights told the court.

Cord cutting has had a big impact.

So as more and more people move away from traditional cable television and move toward services like Netflix and Hulu, the fees that go to the municipalities and townships to invest in this infrastructure are being pulled away from the cities because there's not as many subscribers to the cable companies, and they're going towards Netflix and Hulu, who are using the exact same infrastructure but aren't being required to pay any fee.

Netflix and Hulu argue that they don't provide a video service as cable companies do, but that the streaming services rely on others to get their content out.

So in that instance, the person is providing over the wires and cables is the ISP.

Not Hulu, not Netflix.

We don't control it.

We don't dictate it.

We simply make it available on the Internet, just like this court does.

This session and users, depending on how they want to access the Internet, can then arrange with their ISPs to have it delivered to wires and cables, if that's what it entails.

And the Ohio Attorney General's office which filed a brief in support of Netflix and Hulu, said video service providers are only those which built or own the cables and wires in the public rights of way entities like Netflix and Hulu, which are wholly agnostic to how the video content they provide is actually delivered to their users.

Those entities are not the ones that are tagged under the statute.

The statute is very clear.

This is about those who dig.

They must pay if they don't dig and they don't pay the court session wise as always, being live streamed on its own channel and on the Ohio Channel, which brought some laughs as the city has made the argument that showing the courts sessions or events at churches, schools or other facilities aren't the same as the programing offered by Netflix and Hulu.

Would you recommend Columbus Tax US?

No, I would not, Your Honor, because video programing is defined in the statute as being comparable to that of broadcast television.

And so our allegations are such that an entity like this, I mean, is a pretty good broadcast.

I agree, Your Honor, but they don't provide the same content, quality and general to entertainment that Netflix and Hulu.

How do you know?

We don't know And the lawyer for Hulu took an opportunity with that.

I would submit, having spent all last night watching some of the recorded sessions of this court, that it rivals, if not exceeds the quality of C-SPAN Thank you.

How well was asked about other services such as Roku, Apple TV and YouTube, and said they weren't included, but acknowledged that Netflix and Hulu aren't the only entities that could be affected.

The court will likely deliver a decision in the next few months.

Students are now in the midst of taking required Ohio State tests, and those results later this year are likely to show that learning lost during the pandemic is still real for a huge number of students.

The state has paused punitive penalties against K-through-12 schools as students are not performing well, but as school leaders and lawmakers looking at what can be done to help those kids recover and catch up and also deal with problems outside of school.

The pandemic may have made worse.

In February, Statehouse correspondent Joe Ingles reported on those concerns.

Six of four and a seven, which one of the smaller number of those four aria.

First grade teacher Alyssa Booth says she knows the pandemic has posed special challenges for many of her students at Worthington Park Elementary School near Columbus.

I think one of the things I notice the most is that just the understanding of what school is for them Last year, some of them had a completely virtual kindergarten experience.

Some of them were here half of the time.

Some of them were homeschooled and some weren't even at the school.

So I think the biggest challenge for them has been having that stamina to stay focused long enough and to kind of have that same baseline for everybody to kind of all learn together.

But it's been a huge adjustment since the first part of the school year, but they've come a long way.

Worthington is more diverse than some other suburban Columbus districts, and it usually scores above average on statewide tests.

But even here, teachers know there are kids who need extra help.

Republican Andrew Brenner heads the Senate's K through 12 education committee.

He's been critical of COVID policies such as mask mandates and vaccine requirements.

But he says COVID disrupted learning in all schools as kids and teachers became ill and had to quarantine.

He says some urban districts had a 74% chronic absentee rate, meaning kids had 18 or more days of unexcused absences.

And he says proficiency tests given in key grades last year showed the schools that were most impacted were urban schools with remote learning like Youngstown, for example.

I've been asking people, what do you think the fifth grade proficiency rate was for the fifth grade math class?

In Youngstown City schools?

And I usually get and everybody thinks about it because they know that Youngstown has been under academic stress.

I'll get 2030s and forties as the passage rate.

And then I told them the real number is 2.9%, meaning 97% of the kids failed the proficiency test for fifth grade math in Youngstown.

They said that they outperformed these Cleveland city schools by four percentage points.

That gets people's attention.

And so we've got to do a much better job of working to get these kids back into school, getting them in full time And we need to remediate them.

A review of test scores by the Ohio Department of Education last September noted across the board, students were down about eight points lower in state language arts tests and about 15 points down in math.

Brenner says lawmakers have been talking to leaders at Ohio's colleges about allowing students who are majoring in education to tutor K-through-12 students and maybe even get paid for doing it.

The Ohio Department of Education thinks tutoring is a good idea.

I think there's you know, there's a there's a great interest in tutoring, you know, sort of intensive tutoring.

That's something that I think we're starting to see in other states in the state.

You know, districts are working with different partners and being part of sometime to part of the challenge to speak out, to find a tutor.

I mean, obviously, we've got sort of larger, larger, you know, kind of workforce questions.

But that is definitely something that folks are interesting interested in.

Again, I think you're starting to see some creative solutions.

And then we were talking to some folks in one of, you know, one of the one of our urban districts who was sort of doubling every I mean, the phrase they were using was sort of like back to back teaching where they were sort of bringing two teachers into a room and sort of really focusing and sort of splitting the students, but kind of tag teaming in a bit and bringing in structural resources to it.

Back at the Worthington School District, teachers are using one on one tutoring as well as learning in small groups to deal with kids at different academic levels.

And they're trying to focus on needs that exist outside the classroom to I get to serve as the assistant superintendent of academics.

Sometimes I wish that title was also the assistant superintendent of well-being.

Angie Adrian with Worthington Schools says students who need extra help and resources are being offered those through summer school with the help of community partnerships.

We were worried a little bit about staff.

Our teachers going to be have the energy to come into summer school and teach all summer And they did.

And we had teachers there.

But we also have a really strong food service who provided food for our students.

Transportation jumped on board and said, How do we make sure that we are also a part of the solution and making sure that our students are provided transportation to and from summer school.

And our Worthington Resource Food Pantry stepped up and provided food for our students in summer school as well.

Those wraparound services, such as food tutoring and mental health counseling were seen as important for at risk kids even before the pandemic, and schools are able to use COVID relief funds to support them.

Worthington Elementary School Principal Patrick Geraghty says there's one more thing that's crucial right now focusing on self-control, self-awareness and other skills that help kids work and play together.

The hardest part of all of this is supporting our students with that social, emotional learning and recognizing that we're not getting our consecutive 180 plus days face to face with kids.

We are triaging situations where kids are out of school because they are sick and out of school for things they cannot control based off of close contact.

So really making sure that when we are losing students and not having that in-person, we're finding ways to connect with them outside of the school setting, ensuring they're getting work at their house and making those phone calls, doing zoom sessions when possible, to get those kids connected and really just connecting and making sure they feel comfortable at school Education leaders say there's one thing that's become clear during this pandemic.

Different children have different needs and they say the remedy to lifting up students who are behind is meeting them where they are and making sure they're educational as well as emotional and physical needs are being met but that will take time.

Joe Ingles, Statehouse News Bureau.

The Biden administration announced this week its COVID 19 public health emergency that was set to expire on Saturday will be extended for 90 days till July.

But when it does expire hundreds of thousands of Ohioans who were on Medicaid during the pandemic and weren't dis enrolled will lose that coverage because they'll no longer qualify.

And the state will also lose the increased share of federal Medicaid funds that it's been getting Jon Corlett was the state Medicaid director under Democratic Governor Ted Strickland.

He now heads the nonpartisan public policy think tank, the Center for Community Solutions.

And he's worried about the impact.

Medicaid rolls grew during the pandemic from 2.7.

8 million in February 2020 to 3.3 million two years after that.

There's concern now that the pandemic is winding down.

There will be a lot of people who are still on Medicaid, under expanded eligibility, who would lose that when the federal COVID public health emergency ends.

It's scheduled to end April 15th.

That might be extended to July or maybe even September.

Even if it is, it eventually will end, of course.

How many people could potentially be affected by the ending of the federal COVID pandemic declaration?

I mean, I think it's hard to say in some parts because, you know, remember, you know, we never enrolled everybody who was always eligible for Medicaid.

We always under enroll.

You know, there were lots of people who were eligible who never got on the program and part because sometimes it's difficult to get on the program because you go to these various offices around the state.

But I think know we're talking about probably somewhere in the neighborhood to ten to 15%.

So it could be 200 300,000 people could lose their health care coverage.

And the majority of those will likely be children because children make up the largest share of people enrolled in Medicaid.

One of the reasons has been given is that there are too many people on Medicaid, and it's causing what businesses have talked about as a worker shortage, that they've had a hard time getting people to come back to work or to take jobs.

Is there any evidence that there's a connection between Medicaid and what businesses are calling a worker shortage?

No, there isn't.

I mean, Medicaid is actually one of the greatest work support programs there is because a lot of employers can't afford to offer health insurance.

And so Medicaid is the insurance that their employees count on.

So, I mean, that's we've always seen Medicaid as kind of a work support that it allows people to stay healthy, stay in the workforce, take some pressure off employers to pay for that health care coverage, particularly for lower wage these entry level jobs where we're seeing so many vacancies.

Those are employers that are sometimes the least likely to provide paid health insurance.

And so to have Medicaid, they're, you know, really provides a backdrop backstop for those employers.

The Ohio Department of Medicaid is saying that no one will be dis enrolled without an eligibility redetermination or two failed attempts to obtain verification from the enrollee.

The decision on removing people from Medicaid, though, that window is shortened.

It used to be about six months.

Now it's two to three months, depending on how long a person has been on a high in Medicaid.

Yeah, I think you know, I think the challenge will be is that our our county offices, a job and family services are already overwhelmed they've had a hard time keeping workers just like everybody else.

In fact, I would imagine a large share of the people who are employed by these local agencies have never done a Medicaid redetermination before because they if they've started in the last two years, they've never done it before.

So there's a learning curve for them.

There is a worker shortage for them.

And so I think it can be very challenging.

You know, the general assembly also directed the state to hire an outside contractor to kind of do a pre-check of everybody on Medicaid.

And the way they earn more money is to find people ineligible.

And the group that they are sort of rewarded the most financially because the savings are the largest are aged and disabled people, disabled children.

That's where the state spends the most money.

That's where there could be the most savings.

And so it creates, I think, a strange incentive to sort of maybe try and push people off rather than figure out how do we keep people on.

I think the other challenge, Karen, is around.

You know, I think if you talk to any local job and family service office or if you talk to any Medicaid, HMO or even Medicaid itself, they would acknowledge that their addresses and contact information are not particularly up to date.

They don't know, in fact, where a lot of these people are living.

And so when they send out these notices, they often go to a house that somebody might have lived in one year ago or two years ago.

Poor people move a lot because they can't afford the high cost of housing.

And so that's what I worry about is just going to put a big sort of workload pressure on these local agencies that are going to have a hard time sort of finding these people.

So I appreciate the department sort of making sort of saying we're going to do these three efforts because that's good.

I mean, that's sort of best practice to not just sort of say, hey, we sent the nurse out.

You didn't respond because we know you actually didn't get it, but to say we're going to proactively reach out and try and contact people.

But it's a big job and I think we need to allow those county offices the time to do it and to do it right.

Because the other thing is, if we spend too much time on that kind of what I call paperwork, almost busy work in a way, you know, I'd rather have those local offices focused on program integrity, making sure the program is meeting its goals, making sure that money isn't being spent incorrectly.

Focus on the program integrity side of this and less than trying to chase people off because they didn't check the write box, fill in the right piece of paper, provide the right receipt.

I mean, I think that's shortsighted.

And the other piece, that other challenge it creates will be for big Medicaid providers, for hospitals and others who have a lot of Medicaid patients.

You know, they could very well see large numbers of their patients become uninsured, meaning that they'll have to provide that care and not get reimbursed for it.

And that could create real problems for our behavioral health system, for our big Medicaid providers and for our federally qualified health centers.

I want to circle back to a couple of things that you said.

You said a lot right there.

One of the things that you mentioned was that the state has hired is allowing a vendor called Pcgg to identify people who are potentially ineligible once that public declaration ends.

And they can work with outside sources to gather data on people such as credit reporting agencies.

There could be an estimate of 400,000 people who could be identified like this.

By the state and moved off the Medicaid rolls.

And like you said, this potentially would really impact disabled people and elderly people.

Yeah, and what that firm, though, does, though, is they identify these potentials, people that where they think there might be a question, but then they send that to that local job and family services office they're the ones who actually have to work those cases.

And again, I go back to what I said earlier.

They're the ones who have people who don't have experience of doing this.

They don't are able to fill all the job openings that they have in their county agencies.

I mean, there's a real sort of employee workforce issue there.

So I think the jury's out on how well this may work and I guess the other thing I would say, I think most of us could probably identify a moment where the records about us weren't accurate, where our credit report wasn't accurate.

Maybe our driver's license information, was it accurate?

The government maybe didn't have accurate information about us.

So I think that's I think could be problematic.

And I think you know, they've built in some safeguards to try and sort of guard against that.

But I think, you know, I don't think we should be sort of guided by sort of arbitrary time limits I think we need to give people the time to do this right.

Because if we get it wrong, it means that somebody doesn't get the prescription drugs that they need.

They don't get the medical care they need.

They don't get the behavioral health care therapy that they need because they don't have Medicaid coverage.

I know state lawmakers throughout the conversation about Medicaid that I've witnessed in my 18 years here have talked about responsible city.

And isn't it incumbent upon people who are in the program to make sure that their stuff is up to date, that their information is up to date, so that if they get that notification they can respond to it?

Yeah, I think that's right.

And I think, you know, the state several years ago put up a new system called Ohio Benefits Inc. And I think it's fair to say that that it has not worked as smoothly as as the state might have expected.

And, you know, to their credit, you know, at the end of last year, they finally made that program mobile friendly because before that, if you had a mobile phone and that was the way you used contact with the Internet, it made it very difficult for you to use all your benefits.

So they're trying to do things to make it a better system.

You know, I think the state could probably use the help of Medicaid providers, of doctors and and hospitals and behavioral health agencies to reach out to their patients.

I think we should be encouraging everybody to update their information because it's not just this that you get make this notification.

You make this notification like your snap benefits or your child care benefits.

It is good to have updated information to go to that system and update it updated with your caseworker.

That's a good thing.

When you talk about providers, you're talking about hospitals and those kind of programs.

But also there are the providers who actually work with Medicaid, who are the insurers.

Essentially, what happens if there is broad dis enrollment?

What happens to those because they're depending on that enrollment for their to keep going in the program?

Well, that's a good question, Karen.

Because, you know, obviously, we kickoff a new program on July 1st.

It could sort of parallel, you know, this process.

We're bringing two new Medicaid providers into the system.

So there'll be seven you know, they need an adequate number of covered lives to have a financially viable program.

So if a bunch of people drop off even for a short time, it could make that a little rockier in terms of those programs, self-sufficiency and their able ability to operate.

So I think we have to pay attention to that.

The other thing that we know what will happen is as these people drop off, you know, the people who tend to drop off most of the time, not all the time might be people who are a little healthier.

You know, who aren't using Medicaid every day, maybe used if they were hospitalized or something and got Medicaid coverage in order to pay their hospital bill.

But they might not be on a prescription drug or they might not be seeing maybe a behavioral health therapist every week.

So they're more intimate.

They're less expensive to cover.

When the less expensive people drop off the program, it drives up the costs for the remaining because they're left with sicker people.

That's happened before in Ohio.

And so if the other thing that could happen is it could drive up rates, actually could drive up the rates we have to pay these insurers if too many of the sort of healthier folks because drop off the program because that's what insurance does, it kind of brings all that risk together the healthier with the sicker so that we can all pay, you know, better rates.

When you talk about moving these people out of the program, what happens to families or people who get dis enrolled but they feel that they shouldn't have gotten dis enrolled, that they can they can show that they shouldn't be.

What do they do?

I mean, Medicaid's a maze as it is.

Yeah, I mean, that's a big concern.

And I think and also for new people trying to get on the program, they're going to be among the thousands of other people who are calling that local job and family service office you know where I'm from in Cuyahoga County.

They get 90,000 phone calls a month already.

90,000 phone calls.

You know, three counties in the state, Franklin, Cuyahoga and Hamilton, account for half of the phone calls that the state job and family service officers get from those three counties.

And so the pressure on them will be immense.

And so that's why I think we don't want to set these arbitrary time limits.

You know, let's you know, this it took us a while to kind of work through you know, work through the pandemic.

It's going to take us a while to work out of it.

I think it's a good thing to do.

We don't want people to be on the program who aren't eligible for it.

But we also don't want to lose people who are eligible for it.

And I'm particularly, as I said earlier, concerned about children because they make up the largest share of Medicaid enrollees in the state and they're at risk, too, in terms of losing coverage.

By the way, the contract with the outside vendor, public consultant group or PCG, is a two year deal worth up to $35 million that contract started in October, though no one will be dis enrolled because of a loss of eligibility from Ohio Medicaid till the public health emergency ends in July.

That's it for this week for my colleagues at the Statehouse News Bureau of Ohio Public Radio and Television.

Thanks for watching.

Please check out our Web site at State Newstalk.

And you can follow us on the show on Facebook and Twitter And please join us again next time for the state of Ohio.

Support for the statewide broadcast of the state of Ohio comes from medical mutuel, providing more than 1.4 million Ohioans peace of mind.

With a selection of health insurance plans online at med mutual dot com slash Ohio by the law offices of Porter Wright, Morris and Arthur LLP.

Now with eight locations across the country, Porter Right.

Is a legal partner with a new perspective to the business community.

More at Puerto Rite dot com and from the Ohio Education Association representing 124,000 members who work to inspire their students to think creatively and experience the joy of learning online at OHEA.org