As Ohio debates the Medicaid expansion, a new study from Harvard researchers revealed access to Medicaid in Oregon led to better mental health outcomes and reduced financial strain, but no short-term gains were found in physical health outcomes.The study, which was released Wednesday by The New England Journal of Medicine, had its most positive findings in mental health outcomes, with Medicaid recipients showing 30 percent lower rates of depression in comparison to people without health coverage. Medicaid recipients had a rate of depression of 21 percent, while those without coverage had a rate of 30 percent.But the gains did not apply to physical health outcomes. When looking at cholesterol, blood pressure and blood sugar levels, there was no significant difference between Medicaid recipients and people without coverage. The three measures were chosen because they typically reveal better health results within two years and they're easy to obtain.Still, the study doesn't rule out the possibility of long-term gains. The study found increased rates of diabetes detection and management, which could lead to better physical health outcomes in the future.Medicaid enrollment also reduced financial strain, allowed patients to use more preventive services and nearly eliminated catastrophic out-of-pocket medical expenses, according to the study.The study was conducted by looking at Medicaid recipients in Oregon, which enrolled 10,000 people into Medicaid out of nearly 90,000 applicants through a lottery approximately two years ago, giving researchers the first major randomized pool of Medicaid recipients to study.A previous study from Harvard researchers, including the lead author of the Oregon study, found that Medicaid expansions improved mortality rates, coverage, access to care and self-reported health. That study looked at three states that expanded Medicaid and compared them to neighboring states that did not.The Oregon study comes at a time when legislators are debating whether Ohio should use federal funds to expand its Medicaid program. Even though Republican Gov. John Kasich supports the expansion, Republican legislators say they're concerned the federal funds will eventually dry up, leaving the state to find a solution for hundreds of thousands of new Medicaid enrollees. Democrats are joining Kasich in supporting the expansion, with Ohio Senate Minority Leader Eric Kearney recently calling it a "no-brainer." The Health Policy Institute of Ohio found the Medicaid expansion would insure nearly half a million Ohioans and save the state money in the next decade.The budget bill that recently passed the Republican-controlled Ohio House would forgo the Medicaid expansion while leaving room to consider further Medicaid reforms down the line ("The Chastity Bunch," issue of April 24).

Two Ohio House Republicans are preparing to introduce so-called "right to work" (RTW) legislation, a deceptively named type of law that would ban collective bargaining agreements between unions and employers that require union membership to be hired at a job. Since states began adopting the anti-union laws, union membership has dropped dramatically. Democrats, including gubernatorial candidate Ed FitzGerald, were quick to condemn the bills, invoking 2011's voter rejection of S.B. 5, a bill backed by Gov. John Kasich and Ohio Republicans that would have limited collective bargaining rights for public employees and hindered public sector unions' political power.The city released a memo yesterday outlining how the streetcar project's $17.4 million budget gap will be funded. The memo emphasizes that the capital funds being used for the streetcar project can't be used to balance the city's $35 million operating budget deficit because of state law, so the streetcar project is not being saved at the expense of cops, firefighters and other public employees being laid off to balance the operating budget. CityBeat will have a more thorough analysis of the memo shortly after this article is published.The state auditor released an audit yesterday that shows the Ohio Department of Transportation could save $7.4 million in taxpayer money by mowing the lawn less often. "We need to cut back by mowing less," State Auditor Dave Yost said in a statement. "Sometimes, it’s the simplest solutions that have the greatest impact."A Policy Matters Ohio survey confirmed Ohio schools are making cuts as a result of Kasich's education funding cuts. In total, 70 percent of schools slashed budgets for the 2012-2013 school year.The mayor and city manager held a roundtable with the press yesterday explaining the merits of the city's plan to lease its parking assets to the Port Authority. The city officials made the same arguments heard before about how it would help balance the budget and bring economic development to the city, which CityBeat covered in further detail here.If estimates are correct, this year's Flying Pig Marathon will bring $9.5 million into Greater Cincinnati's economy.In light of grim drug addiction and overdose statistics recently released, Ohio Sen. Rob Portman says it's time to call the "war on drugs" something else. The most recent data found one Ohioan died of a drug overdose every five hours on average in 2011.Next Tuesday is primary election day in Ohio, but there isn't much to vote on in southwest Ohio.Steve Smith, who admitted to raping and killing a six-month-old in Mansfield, Ohio, will be executed by the state today, but his relatives insist he didn't do it.Gladys, the unfortunately named gorilla at the Cincinnati Zoo, recently got a look at her new home.Antimatter is the opposite of matter, but it's unclear whether it falls up or down.

The Democratic Party’s nominating committee announced who it’s supporting for City Council Friday: Greg Landsman, who heads the Strive Partnership and worked for former Gov. Ted Strickland; Shawn Butler, Mayor Mark Mallory’s director of community affairs; Michelle Dillingham, a community activist; and the six incumbents, which include Laure Quinlivan, Chris Seelbach, Yvette Simpson, P.G. Sittenfeld, Pam Thomas and Wendell Young. The nominations still have to be approved by the Cincinnati Democratic Committee. Petitioners against the city’s parking plan are supposed to get their final tally on referendum today, but a new video shows at least some of the petitions may have been signed without a legitimate witness, which are needed to validate a signature. The Hamilton County Board of Elections announced Thursday that petitioners had met the necessary threshold of 8,522 signatures, but the video casts doubts on whether those signatures were legitimately gathered. The city wants to lease its parking assets to help balance the deficit for the next two years and fund development programs around the city (“Parking Stimulus,” issue of Feb. 27), but opponents worry higher parking rates and extended hours will harm the local economy. Here is the embedded video: The Ohio Senate could restore Gov. John Kasich’s tax, school funding and Medicaid plans when it votes on the biennium budget for 2014 and 2015. Kasich’s tax and education funding plans were criticized by Democrats and progressive groups for favoring the wealthy, but the Medicaid expansion, which the Health Policy Institute of Ohio says would expand Medicaid coverage to 456,000 low-income Ohioans and save the state money, was mostly opposed by state Republicans. CityBeat covered Kasich’s budget in further detail here. New polling from Quinnipiac University found a plurality of Ohio voters now support same-sex marriage rights — granting promising prospects to Freedom Ohio’s ballot initiative to legalize same-sex marriage in the state this year. An audit on JobsOhio could take months, according to State Auditor Dave Yost’s office. Gov. John Kasich was initially resistant to a full audit, but Yost eventually won out, getting full access to JobsOhio’s financial records. JobsOhio is a privatized development agency that is meant to eventually replace the Ohio Department of Development. In response to not getting a Democratic endorsement for his City Council campaign, Mike Moroski, who was fired from his job at Purcell Marian High School for supporting gay marriage, launched the Human Party. Cincinnati received an “F” for business friendliness in the 2013 Thumbtack.com U.S. Small Business Friendliness Survey from the Ewing Marion Kauffman Foundation. Embattled attorney Stan Chesley will no longer practice law in Ohio. Chesley, who has been criticized for alleged misconduct, was recently disbarred in Kentucky. He recently resigned from the University of Cincinnati Board of Trustees after being asked to in a letter from fellow board members. Ohio gas prices are shooting back up. PopSci has an infographic showing sharks should be much more scared of humans than humans should be afraid of sharks.

Ohio House Republicans are poised to reject the Medicaid expansion and the $500 million per year in federal funding that would come with it for the next two years — a move that has united Republican Gov. John Kasich, Ohio Democrats, mental health advocates and other health groups in opposition. The Medicaid expansion is part of a measure in the Affordable Care Act (“Obamacare”) that encourages states to expand their Medicaid programs to include anyone at or below 138 percent of the federal poverty level with the use of federal funds. For the first three years, the federal government would pick up the entire tab for the expansion. After that, payments would be phased down over time so the federal government would be paying 90 percent of costs. Ohio House Republicans oppose the measure because they say they’re worried federal funding will dry up in the future, even though there is no historical precedent of the federal government failing to pay its commitment to Medicaid. Kasich’s proposal for the Medicaid expansion includes an automatic trigger that would immediately stop and retract the expansion if federal funding falls through, but Ohio Republicans previously voiced concerns in hearings that the trigger would hurt Ohioans who have become accustomed to government-provided health insurance without any plan to make up for the lost coverage. A report from the Health Policy Institute of Ohio found the expansion would help insure 456,000 Ohioans by 2022 and save the state money in the next decade by producing economic growth and shifting health-care expenses from the state to the federal government. For advocates of mental health and addiction treatments, Ohio House Republicans’ rejection of the Medicaid expansion and other budget items means mental health and addiction services will miss out on $627 million per year, according to a report from the Office of Health Transformation. Ohio House Republicans’ budget plan would include $50 million more annual funding for mental health and addiction services, but that’s also not enough to make up for the $140 million in annual funds cut around the state since 2002 and the $17 million being cut over two years through the dissolution of the tangible personal property tax replacement funds. Cheri Walter, chief executive officer of the Ohio Association of County Behavioral Health Authorities (OACBHA), says the Medicaid expansion is a great opportunity to emphasize mental health services around the state. “On the mental health side, ... sometimes it can take two or more years for someone to get a disability determination that makes them Medicaid eligible,” she says. “In addition to making more people Medicaid-eligible, it will speed up the process for many others.” Walter says for addiction patients in particular, getting access to health services can be difficult because alcoholism and other forms of addiction are not technically disabilities. By including more income levels in the Medicaid program, less people will fall through the cracks, she says.OACBHA was one of the many groups that rallied at the Ohio Statehouse Thursday in support of the Medicaid expansion. The crowd, which received support from Ohio Democrats and Kasich, was estimated to reach 2,500. Until the U.S. Supreme Court ruling on Obamacare, the Medicaid expansion was required, but the court ruled that states must be allowed to opt in and out. The Medicaid expansion was one of the few parts of Kasich’s budget plan that Democrats and progressives approved, while the two other major proposals in Kasich’s plan — school funding and a tax cut proposal — were criticized for disproportionately benefiting wealthy Ohioans (“Smoke and Mirrors,” issue of Feb. 20).

Democrats are calling for the resignation of Ohio State Board of Education President Debe Terhar, who compared President Barack Obama to Adolf Hitler in a Facebook post. The Columbus Dispatch reported Terhar posted an image of Adolf Hitler on her personal Facebook page that read, “Never forget what this tyrant said: ‘To conquer a nation, first disarm its citizens.’ — Adolf Hitler.” Terhar, a Cincinnati Republican, insists she was not comparing Obama to Hitler. She told The Dispatch that people who know her understand she was describing the “need to step back and think about it and look at history.”When looking at history, there is no evidence Hitler actually said the quote in question. The Nazi leader referenced disarming the “subject races,” according to Hitler's Table Talk, but the direct quote Terhar posted is unverifiable. “I’m not comparing the president to Adolf Hitler,” Terhar said. “It’s the thought of disarming citizens, and this has happened throughout history. What’s the true intention of the Second Amendment? It was to protect us from a tyrannical government, God forbid.” Terhar’s stance could have an impact on school policies. She told The Dispatch, “Schools are gun-free zones. If you have someone who is bent on causing harm, where are they going to go? To a place where there is little chance of resistance.” But when looking at different countries and states, the Harvard Injury Control Research Center found a correlation between more guns and more homicides. More specifically, men and women in places with more firearms are at a larger risk for gun-related homicide. Terhar was elected Jan. 14 by the 19-member Ohio State Board of Education to serve as president.

In light of Michigan’s progress in passing a so-called “right-to-work” law, Ohioans are both worried about and pushing for a similar law allowing workers to opt-out of paying union dues at businesses where workers are represented by a union. Tea party activists are working to gather the 380,000 signatures needed to get the Ohio Workplace Freedom Act on the ballot. They have until July 3. The Michigan House of Representatives on Tuesday passed the first of two right-to-work bills, both of which were passed by the state Senate last week. Gov. Rick Snyder has told multiple media outlets that he could sign the bills as early as Wednesday. Michigan would be the 24th right-to-work state in the nation and the second in the Midwest. Indiana passed a similar law earlier this year. Members of the Ohio House Democratic Caucus wore red carnations — Ohio’s state flower and a symbol of the labor movement — at the Statehouse Tuesday to show support for Michigan workers. “Put simply, so called ‘right to work’ is wrong. Statistics show states with this anti-working family legislation have lower wages and higher poverty rates,” Ohio state Rep. Connie Pillich, D-Montgomery, wrote in an emailed statement.  “We will continue to stand together and fight against these unfair attacks on workers in Ohio, Michigan and across the country.” Despite the effort to put a right-to-work law on the ballot next year — a similar effort was unsuccessful in 2012 — it doesn’t seem like Ohio is in any rush to join Michigan and Indiana. The Columbus Dispatch reports that Ohio Gov. John Kasich has higher priorities than passing a right-to-work law. The newspaper reports that Ohio added 127,000 jobs in the past two years and ranks fourth nationally and first in the Midwest in terms of job creation.  Kasich said the agenda for the last two years of his first term include tax cuts, an education overhaul and infrastructure improvement to keep the state competitive. “I have an agenda that I think is going to benefit the state of Ohio,” Kasich told the newspaper. “We’re doing very well vis-a-vis the rest of the country now, and I think if we continue to pursue the agenda I have and the legislature has, I think we’ll continue to be successful.”FUN FACT: Michigan's right-to-work bill will be signed into law in the Romney Building. George Romney, former Michigan governor and father of Republican presidential candidate Mitt Romney, was an opponent of right-to-work laws.