Ohio Counseling Conversations

Couch to Capitol: December Legislative Updates & Year-End Recap

• Ohio Counseling Association

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Laws and budgets rewired the counseling landscape this year, and the ripple effects reached every waiting room in Ohio. We unpack what changed, what stalled, and where small advocacy moves can still flip outcomes—especially around parity, youth privacy, LGBTQ protections, and the counseling workforce pipeline.

We start with the three forces that kept shaping care: access as infrastructure, higher education as the pipeline, and culture-war policy as clinical reality. From the federal pause on enforcing the MHPAEA Final Rule to Ohio bills that would narrow minors’ confidential access, we connect the dots between committee rooms and client sessions. You’ll hear clear updates on House Bills 172, 162, 390, 415, 324, and 249; the status of the Counseling Compact and why implementation timing matters; and how budget decisions affected libraries, shelters serving trans and non-binary youth, and coverage for gender-affirming care. We also chart the impact of Medicaid proposals, SNAP stability, and payment reforms that determine whether practices can keep doors open.

We dig into telehealth flexibilities during the federal shutdown, the end of specialized 988 support for LGBTQ youth, and why misinformation around school screenings and reproductive health fuels shame and avoidance. On the horizon: proposed federal loan caps for non-doctoral graduate programs set to reshape who can afford a CACREP-aligned counseling degree and who gets left on a waitlist. Throughout, we translate policy into practice—what it means for denials, documentation, caseloads, and the trust needed to do effective therapy.

Walk away with a focused watchlist for 2026: parity enforcement, insurer practices, telehealth stability, youth confidentiality, affirming care protections, Medicaid policy, and student loan rules. Subscribe, share with a colleague who needs the quick policy download, and leave a review telling us the top policy you want us to track next.

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Created by the OCA's Media, Public Relations, and Membership (MPRM) Committee & its Podcast Subcommittee

·Hosted by Dr. Chase Morgan-Swaney

·Pre-Production & Coordination by Marisa Cargill, Victoria Frazier, Mariah Payne, and Chase Morgan-Swaney

·Editing by Marisa Cargill


SPEAKER_00:

Welcome to Ohio Counseling Conversations Cat to Capital, your quick connection from the counseling office to where laws meet lies. In 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.

SPEAKER_01:

Hello, everyone, and welcome back to Couch to Capital, a monthly segment of Ohio Counseling Conversations that debuted in May of this year. I'm Dr. Chase Morgan Swainey, and I'm honored to serve as president-elect of the Ohio Counseling Association. Today's episode is our year-end recap. We're going to take a fast practical lap through the major counseling-relevant policy threads we tracked in Couch to Capital this year. And I'll also share where things stand right now, so you're not left with yesterday's headlines. Quick note before we jump in legislation moves, committees change, timelines shift, the courts ensnare policies. So think of this as your snapshot recap, plus clear next steps if you want to stay engaged. If I had to summarize this year in three themes, it would be first, access to care is still an infrastructure problem. That includes insurance barriers, parity, workforce pathways, telehealth rules, and the reality that people can't benefit from counseling they can't afford or can't get to. Second, higher education policy matters for the counseling workforce pipeline. We tracked major changes that affect campuses, students, and how future counselors are trained and supported. And lastly, culture war policy is not abstract. It lands in our counseling spaces. We discussed policies affecting LGBTQ clients, minors access to sensitive information and services more broadly, and the chilling effects that ripple through families, schools, and our communities. So with those three themes in mind, here's our quick month-to-month recap. In May, our first big federal headline was parity. The Departments of Labor, Health and Human Services, and Treasury announced they would pause enforcement of the 2024 Final Rule for the Mental Health Parity and Addiction Equity Act. Translation: Parity is still the law, but the newer enforcement muscle aimed at things like prior authorization, network adequacy, and step therapy got put in limbo because of litigation. For counselors and clients, that can mean more denials, more delays, and more time spent fighting systems instead of doing and receiving care. May also brought a very practical issue: getting paid. We broke down proposed changes related to electronic fund transfers and how payment methods and fees can create very real strain on practices and agencies. Then we put a bright light on youth access. We tracked House Bill 172, which would repeal, if enacted, the Ohio provision that currently allows minors in crisis to access mental health services without parental consent for a period of time. We emphasize something critical. These policies don't stay theoretical. They shape whether youth reach out at all and whether counselors can create conditions for safety. As of now, House Bill 172 sits in the health committee, where it has received three hearings, including most recently an opponent testimony hearing in which OCA submitted testimony against the bill. We also flagged House Bill 277, addressing how healthcare workers using digital staffing platforms could be classified as independent contractors and what that might mean for parts of the behavioral health workforce. As of now, House Bill 277 sits in the Commerce and Labor Committee. It has received one committee hearing since June. So where do things stand now? At the federal level, parity enforcement is still in a complicated place due to litigation and shifting enforcement timelines. So it's a watch closely area, not a set it and forget it area. And in Ohio, several bills we flagged early in the year largely remain in committee status, meaning advocacy and education still matter because committee rooms are often where outcomes are decided. June was Pride Month, and we talked about how budget language in the Ohio budget and related policy proposals can directly affect LGBTQ youth and the counselors who serve them. We also had a bright spot we want to name clearly. Ohio's 988 Suicide and Crisis Lifeline received an increase in funding, set to take effect in fiscal year 2026. 988 matters because it's often the front door to life-saving support and demand is increasing. And we zoomed out to the courts. We discussed the United States Supreme Court's decision and United States versus Skermetti and what it could signal nationally. And we connected that to Ohio's ongoing legal and legislative landscape, including House Bill 68 and the related case Mo vs. Yost. July was a big month for budgets, both state and national. In Ohio, Governor DeWine signed the state budget on June 30th and issued dozens of vetoes. We walked through the vetoes that mattered to counselors, including items affecting libraries, shelters serving trans and non-binary youth, and restrictions around flags on state property. At the same time, we made it clear some harmful provisions still made it into the final budget, including measures that reinforced a rigid binary framing of sex and policies that could affect coverage for gender-affirming care. Even when a veto happens, the ripple effects of what remains land directly in our laps as counselors. Nationally, we covered HR one, the so-called one big beautiful bill, and why Medicaid policy is counseling policy. We discussed how proposed Medicaid cuts can reduce access to counseling for clients across Ohio, especially rural communities, and how changes to SNAP can amplify stress and instability. We also highlighted House Bill 390, a pro-provider bill that would shift responsibility for collecting co-pays and deductibles from providers to insurers and require reimbursement for covered services to be paid directly to providers. As of now, House Bill 390 sits in the Insurance Committee, where it has received one hearing since October. August brought major counseling workforce news. Momentum continued to grow for the Counseling Compact, and we talked about what it can mean for professional mobility and continuity of care across state lines. But August also brought serious concern. We discussed SAMHSA's decision to end specialized 988 support for LGBTQ youth and why affirming specialized crisis support is not extra. It's life-saving. We also covered the Federal Trade Commission, considering whether to label gender-affirming care an unfair or deceptive practice, and we encourage counselors to submit public comment. Back in Ohio, we discussed ballot initiatives related to equal rights protections and highlighted House Bill 415, the Crown Act regarding discrimination based on hair, because school climate is mental health. As of now, House Bill 415 sits in the Education Committee, where it has received three hearings, the most recent in October. And we covered a major national funding hit. The Department of Education canceling significant school mental health funding under the Bipartisan Safer Communities Act. At a time when youth mental health needs are urgent, the loss of those supports are real and they have downstream consequences for students, families, and the professionals trying to serve them. So where do things stand? The counseling compact continues to grow across states, but past is not the same as live. Implementation details and timelines matter a great deal. As of now, only Arizona and Minnesota have gone live and can issue practice privileges through the compact. Good news, all signs point to Ohio being one of the next states to go live. Stay tuned for more information from our licensure board. September put the counseling pipeline front and center. We discussed Senate Bill 1, the Advanced Ohio Higher Education Act, and how Ohio institutions were beginning to respond, including program eliminations tied to low enrollment thresholds and new compliance expectations. We also stayed on telehealth because access does not begin and end at a clinic door. We talked about Congress considering a stopgap continuing resolution, ultimately leading to the most extended government shutdown in American history, in the importance of including telemetal health flexibilities in the continuing resolution. And we addressed a theme that kept popping up this year: misinformation. We discussed political pushback against school-based mental health screenings and how stigma grows when mental health stays hidden. We also discussed high-profile misinformation around reproductive health and autism because public narratives shape clients' fears, shame, and decision making long before they step into our offices. In October, our colleague Mariah Payne took the mic and walked listeners through the federal government shutdown and the real-time disruptions that can follow, including changes to telehealth waivers and billing uncertainty. We also talked about the risk of interruptions to SNAP benefits and why counselors may need to boost resource lists and concrete supports. October and November also kept youth privacy on the radar. We discussed House Bill 162, the My Child My Chart Act, and why confidentiality is often the condition that makes adolescent help seeking possible. We emphasize the ethical and clinical implications, not just the political debate. Since then, House Bill 162 passed the Ohio House and has been assigned to the Senate Health Committee, where it is yet to receive any hearings. We also discussed House Bill 324 and the mental health impact of reproductive restrictions. Political decisions about bodily autonomy can become political trauma, and counselors are often supporting clients through the anxiety and grief that follow. As of now, House Bill 324 passed the Ohio House and has been introduced in the Senate. It has yet to be assigned to a committee. And in November, we covered House Bill 249 and how vague, sweeping restrictions targeting LGBTQ communities can create systemic stress that counselors then help clients carry. As of now, House Bill 249 has been assigned to the Judiciary Committee, which has held two hearings on the legislation, the most recent in October. Finally, we ended the year on a workforce issue that could reshape the future of counseling. Proposed federal student loan caps for nondoctorate graduate programs beginning July 1st, 2026. If counseling students can't afford to enter KRAP aligned programs, that impacts the entire system. Fewer counselors, longer wait lists, reduced access, especially in rural and underserved communities. The American Counseling Association will submit comments on these proposed changes to the Department of Education during their public comment period, which is anticipated to begin in early 2026. You can act now. Share how student loans supported your journey to becoming a licensed professional counselor and how the proposed loan limits would negatively impact future students' educational and professional trajectories. Listeners can find the link to share their stories with ACA in the show notes for this episode. So what do we carry into 2026? Keep watching parity enforcement and insurer practices, telehealth flexibilities, youth confidentiality legislation, policies that restrict affirming care, and anything that shrinks the counseling workforce, including Medicaid policy and student loan rules. And remember, advocacy does not have to be complicated. Stay informed through OCA updates. Contact your legislators when a bill affects your clients, and connect with OCA when you want a path to get involved. According to the American Counseling Association, Ohio was among the top five most active states in responding to their federal advocacy action alerts. Let's keep it that way in 2026. Thank you for spending this year with us on Couch to Capital. If this recap was helpful, share it with a colleague, subscribe so you don't miss next month's updates, and keep advocating. Speaking of, stay tuned to OCA socials for information about our 2026 Legislative Advocacy Day. From the Ohio Counseling Association and Ohio Counseling Conversations, take care of yourselves, take care of each other, and we'll see you in 2026.

SPEAKER_00:

That's it for this edition of Catch 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 counsel in Ohio. Because what happens at the Capitol doesn't stay at the Capitol, it impacts every counseling conversation.