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Legal Uncertainties Remain Following Passage of Issue 1 in Ohio

Client Alert

In the November 2023 General Election, Ohio voters passed Issue 1 which, among other things, “[e]stablish[es] in the Constitution of the State of Ohio  an individual right to one’s own reproductive medical treatment, including but not limited  to abortion”. Despite passage of Issue 1, questions persist about how its codification on December 7 affects previously passed legislation restricting abortion and related pending court cases.

On the day the ballot measure became effective, Ohio Attorney General Dave Yost said that Ohio’s new constitutional right to reproductive decisions overrides the state’s ban on most abortions (the previously passed “Heartbeat Law"), but that the state’s appeal of a lower court’s decision to pause enforcement of the Heartbeat Law should go forward.

On September 2, 2022, in Preterm-Cleveland v. Yost, five groups, including the American Civil Liberty Union (ACLU) of Ohio, filed a lawsuit in Hamilton County Common Pleas Court seeking to block enforcement of the Heartbeat Law. The Hamilton County Common Pleas Court held that abortion is a “fundamental right” and that the Heartbeat Law violates that right. The court issued a preliminary injunction in October 2022, preventing enforcement of the Heartbeat Law.

In response, Ohio Attorney General Yost appealed the preliminary injunction to the First District Court of Appeals, which ultimately dismissed the case. Yost appealed to the Ohio Supreme Court, asking the court to rule on two important issues:

  1. Can preliminary injunctions that restrict state law be appealed by the state?
  2. Because Ohio courts lack jurisdiction to issue injunctive relief to parties who lack standing, can third parties (e.g., abortion clinics) challenge state laws (in this case, the Heartbeat Law)?

Following passage of Issue 1, the Ohio Supreme Court asked both sides to file new briefs that address the impact of Issue 1 on the case pending before it. In Attorney General Yost’s brief, he argued that the law itself is not at issue, but rather the two procedural issues described above. In his brief, Yost indicated that, substantively, Issue 1 overrides the Heartbeat Law.

In its brief submitted on behalf of the Appellees, the ACLU of Ohio argues that Issue 1 renders the Heartbeat Law unenforceable and that Yost’s prior appeal of the 2022 preliminary injunction of that law is moot, rendering the case unable to proceed. According to the brief, because the State cannot be harmed by being prevented from enforcing a law that Attorney General Yost admits violates the Ohio Constitution, there is no harm for the State to allege.

While the Supreme Court of Ohio considers both briefs, many providers of reproductive health care in Ohio are waiting on concrete legal guidance before they stop following Ohio's current abortion restrictions, including requiring patients to wait 24 hours after an initial appointment to have an abortion. The Supreme Court of Ohio’s ruling on the procedural issues stemming from Issue 1 should clarify the new legal boundaries for providers.

If you have questions about the content of this Client Alert, or the passage of Issue 1, please feel free to reach out to BMD Member Daphne Kackloudis at dlkackloudis@bmdllc.com or BMD Partner Ashley Watson at abwatson@bmdllc.com.


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Updated Guidance on Ohio Department of Medicaid Telehealth Rules During the Covid-19 Public Health Emergency

In its initial response to the COVID-19 public health emergency, the Ohio Department of Medicaid (“ODM”) issued emergency rule 5160-1-21, which dramatically expanded reimbursable telehealth services, telehealth providers, allowable technology, location of both providers and patients, and covered billing provider types. See BMD’s initial COVID-19 and Telehealth Resource Guide here. This emergency rule provides wide flexibility for patients to receive necessary healthcare services while Ohio’s Stay-At-Home Order remains in place. Regulations are continually changing in response to the public health crisis, and on April 13, 2020, ODM issued new guidance further expanding telehealth services reimbursable under Ohio’s Medicaid program.