Here they go again. Republicans are renewing their anti-abortion agenda in Ohio. Two of the governor’s October appointments have been criticized by a pro-choice group, and the state legislature is now considering a new version of the heartbeat bill. Yesterday, Senate President Tom Niehaus told The Cincinnati Enquirer that the Ohio legislature, in cooperation with anti-abortion groups, is giving another look at the heartbeat bill. When the heartbeat bill was first suggested, many on the left labeled it the most radical anti-abortion bill in the country. If it became law, the bill would have banned abortion as soon as a fetal heartbeat is detected, which is typically visible in ultrasounds by the sixth week of pregnancy, with no exceptions for rape, incest or the health of the mother. Legislators and anti-abortion groups aren’t offering specifics on the new bill. Ohio Right to Life opposed the heartbeat bill when it was first suggested because the group believed it was too likely to fail in front of the U.S. Supreme Court, which upheld abortion rights in Roe v. Wade in 1973. The new version of the heartbeat bill will likely be retooled to sustain any court challenges. Kellie Copeland, executive director of NARAL Pro-Choice Ohio, says Republicans haven’t taken the right lessons from the Nov. 6 election: “It’s clear that they didn’t get the memo. Pro-choice Ohioans overwhelmingly voted to re-elect President Obama and reject this war on women. Here we are, we haven’t even made it to the weekend, and our senate president is resuming attacks on women’s reproductive health care.” She added, “I think they didn’t care what Ohio women thought before the election, and it’s clear they don’t care now either.” In response to questions about whether the governor will support a new heartbeat bill, Rob Nichols, spokesperson for Republican Gov. John Kasich, said in an email, “We are watching the Senate’s activity closely.” A few appointments from Kasich have also come under scrutiny. On Oct. 12, Kasich appointed Marshall Pitchford, a board member at Ohio Right to Life, to a committee in charge of filling a vacancy in the Ohio Supreme Court. On Oct. 29, Kasich appointed Mike Gonidakis, Ohio Right to Life president, to serve a five-year term on the State Medical Board of Ohio, which is in charge of the state’s medical regulations. In a statement, Copeland criticized the appointment to the Supreme Court committee: “Because legislation promoted by Ohio Right to Life is likely to come before the Ohio Supreme Court, it is inappropriate for Pitchford to be placed in a position where he can cherry-pick a justice to serve on that court.” She also criticized the appointment of Gonidakis to the State Medical Board. Copeland says she’s “concerned” that he’s on the board to regulate and restrict access to abortions. “No group in the state of Ohio has done more to interfere with the private medical decisions of Ohio women,” she says. “For their leader to now be on the State Medical Board is completely inappropriate and disturbing.” She added that the two appointments show Kasich is “playing a more active role in the war on women than Ohioans realize.” According to Gonidakis’ biography on the Ohio Right to Life website, Gonidakis went to school for law at the University of Akron. No professional medical experience is noted. Nichols said in an email the appointments should come as no surprise: “The governor believes strongly in the sanctity of human life, so it's a surprise that someone would be surprised that he practices what he preaches.”

In-person early voting is underway in Ohio. Find your nearest polling booth here. The final presidential debate between President Barack Obama and Mitt Romney was last night. The general consensus from media pundits is Obama won by a substantial margin. But political scientists say debates typically have negligible electoral impact. In aggregate polling, Obama is up in Ohio by 1.9 points and Romney is up nationally by 0.6 points. Ohio is looking like a must-win state for both campaigns, so Obama’s advantage there is a very bad sign for Romney. FiveThirtyEight, The New York Times’ election forecast blog, has an explanation of how and why the current electoral landscape favors Obama.    In a follow-up to the debate, Romney will be visiting Greater Cincinnati Thursday. A new motion by City Councilwoman Laure Quinlivan could encourage more people and businesses to make use of the city’s LEED program. The program uses special tax exemptions to encourage buildings to be cleaner and greener.  Cincinnati’s City Planning Commission approved Plan Cincinnati Friday. With the approval, the plan’s only hurdle is City Council. If passed, the plan will reform city policies to put a new emphasis on the city’s urban core. That means a cleaner, greener city with more transportation options, ranging from walking and biking to the streetcar and rail. CityBeat wrote about Plan Cincinnati here. The full plan can be found here.   Three Republicans in the state legislature, including Cincinnati’s Sen. Bill Seitz and Rep. Louis Tehrar, introduced a bill that would require health insurance providers to cover autism. Critics say the move could cost small businesses too much during an economic downturn, but supporters say it’s necessary to Ohio’s mental health coverage requirement, which was passed in 2007. Seitz says the bill could also save money by bringing down special education costs. In a sign of Ohio's education funding problems, one report found two of three Ohio school levies are asking for additional funding. But Cincinnati Public Schools’ (CPS) levy will only not ask for extra funding or higher taxes; instead, it asks for funding and taxes to remain the same. CityBeat covered Issue 42, the CPS levy, in-depth here.  A new report found Ohio students graduate with more debt than most of the nation. The report named the state a “high debt state” with an average of $28,683 in student loans — above the national average of $26,600. Despite what a recent conflict between Commissioner Greg Hartmann and Mayor Mark Mallory implies, Cincinnati and Hamilton County are working together. The city and county are cooperating on the Banks project, funding the Port Authority and operating the Metropolitan Sewer District.  Cincinnati is working harder to enforce a chronic nuisance disorder. A property is classified as a chronic nuisance when it surpasses a certain amount of crimes and violations. The law is meant to hold property owners accountable for what happens in their buildings. There are more signs that Ohio’s fracking boom may not be sustainable. Natural gas producers are not seeing the profits they expected from the boom. For many, the boom is quickly turning into a bust. Still, natural gas prices have massively dropped, and an analysis at The Washington Post suggests natural gas could play an important role in reducing carbon emissions. CityBeat wrote in-depth about the fracking boom in Ohio and the faulty regulations on the industry here.  The Ohio Board of Regents is using a grant to award 1,300 associate degrees to transfer students over two years. Fourteen recreational trails in Ohio will get $1.6 million in federal funding, according to the Ohio Department of Natural Resources. However, none of the trails are in Hamilton County.The key to humanity: cooked food.

Following a national trend, Ohio's minorities have the lowest levels of health care coverage, according to a new study from The Henry J. Kaiser Family Foundation. The study looked at 2006-2008 data for only men to gauge health insurance coverage and other health issues in a pre-Obamacare world. In Ohio, Hispanics have the highest rates of no coverage at 40.1 percent. Blacks are second with 25.3 percent having no coverage. Meanwhile, only 14.6 percent of whites have no coverage. The disparity is prevalent on a national level. Hispanics still lead the nation with rates of no coverage at 46 percent, but Native Americans overtake blacks on a national level with a rate of 38.5 percent. Blacks are 28.8 percent, Asians and Pacific Islanders are 21 percent, and whites are 15.7 percent. The study assigned “disparity scores” to measure the racial disparity in health care coverage. The national average score was 2.27. Ohio did better than most of the nation and its neighbors with a score of 1.83. Kentucky was rated 2.06, Indiana 2.14 and Michigan 1.86. Pennsylvania and West Virginia beat out Ohio with scores of 1.74 and 1.31, respectively. The study also looked at access to personal doctors and health care providers. Ohio did a little better in this category among Hispanics. The study found 30.5 percent of blacks had no access to a personal doctor or health care providers, while 27.6 percent of Hispanics did not. Whites remained at the top with only 21.1 percent not having access to a personal doctor or health care provider. For black men, the most striking national health disparity was that black men were more than seven times more likely as white men to be diagnosed with AIDS. For every 100,000 men, 104.1 black people were newly diagnosed with AIDS. Hispanics were second with 40.8, then Native Americans at 17.3, then whites at 13.7, then Asians and Pacific Islanders at eight. Overall, the study assigned a 4.37 disparity score to AIDS diagnoses nationwide. In Ohio, the rates of new AIDS cases were better overall, but the disparity score was worse than the national average at 5.23. Among whites, only 7.3 out of 100,000 were newly diagnosed with AIDS. Blacks were 46.2, Hispanics were 26.1, Native Americans were 9.8 and Asian and Pacific Islanders were 1.6. The report also looks at poverty levels, incarceration rates, routine checkups, unemployment, the wage gap and more. The full report can be found here. Ohio Medicaid Director John McCarthy said on Sept. 26 Ohio might expand its Medicaid program, but at lower levels than Obamacare demands. Using the incentive of federal Medicaid dollars, President Barack Obama’s health care reform asks states to expand their state Medicaid programs to include everyone at or below 138 percent of the federal poverty level. The requirement overlaps with the newly established exchanges, which cover individuals between 100 percent and 400 percent of the federal poverty level by providing a market in which insurance companies compete for customers getting federal subsidies for health insurance. McCarthy said he would like to eliminate the overlap and only expand Medicaid to cover up to 100 percent of the federal poverty level. Historically, Medicaid helps minorities the most. Medicaid expansions in other states also showed improvements in health and mortality rates while saving money by eliminating the amount of uncompensated care.

Hamilton County commissioners will vote on levies today. If commissioners do not increase the money levies generate, mental health services could be severely cut in Hamilton County. On Aug. 1, Thomas Gableman, Mental Health and Recovery Services Board Chairman, told the commissioners, “I cannot tell you we can do more with less. We cannot do the same with less. We will do less with less.”Republicans, including local state representative candidate Mike Wilson, have been pushing false information regarding a lawsuit filed by President Barack Obama and the Democratic Party to restore early voting. After releasing a misleading press release, Wilson clarified his position to CityBeat. Politifact rated Mitt Romney’s accusations “False.”Ohio Attorney General Mike DeWine is calling for new regulations on internet cafes. Internet cafes have been taking advantage of legal loopholes to hold contests, according to a press release from DeWine’s offices.Ohio could finish the 2013 fiscal year with a $408 million surplus. The surplus could give more ground to Gov. John Kasich’s call for an income tax cut.The swine flu outbreak in Ohio is being watched carefully by CDC officials. The CDC is worried the virus could mutate, making it deadlier or more contagious.Ohio Secretary of State Jon Husted has a big announcement about elections tomorrow. One reason for high health-care costs may be the fee-for-service model. The model encourages doctors to provide as many medical procedures as possible, even when they might not be necessary.Cincinnati Symphony Orchestra saw attendance and subscriptions rise in the 2011-2012 season.There are super PACs for everything. Even time travel.The public may be excited about NASA’s current mission, but future missions could be in jeopardy due to funding reductions.

City Council is expected to vote this morning to divert the $4 million for the City Hall atrium project to jumpstart the Music Hall renovation, which has brought the city and arts supporters interested in owning and operating the historic venue closer to a compromise. Council could vote on the renegotiated deal later Wednesday, though details of the lease agreement have yet to be released.  Council is also expected to approve a property tax increase of $10 per $100,000 in valuation to fund capital projects such as a new West Side police station and additional road paving.  Today’s Hamilton County Transportation Improvement District meeting will include a presentation about the Brent Spence Bridge that will probably include polls. Gov. John Kasich today will sign a human trafficking bill that makes the crime a first-degree felony rather than second-degree and includes funding to help victims.    The ACLU will represent the Ku Klux Klan in a legal fight involving Georgia’s highway cleanup program and a pending First Amendment lawsuit.   The U.S. Supreme Court on Thursday will rule on President Obama’s health care law.  Obama and Biden are still jamming Romney up on his outsourcing history.  A Walgreens store and other pharmacies in Washington, D.C. are offering free HIV tests to make diagnosing the disease more convenient and to increase awareness.  College football has approved a four-team playoff to determine its national championship rather than the computer-human two-team plan that has faced scrutiny over the years. The new format will start in the 2014-15 season. 

In yet another effort to save tax dollars and fill holes in the state budget, Ohio Gov. John Kasich and his health care advisers will streamline the state’s Medicaid system by altering the availability to care plans and condensing care regions. There are currently 38 health plans and 10 regions in the state of Ohio, which provide services to more than 1.6 million Ohioans each year. When changes in the system are implemented January 1, 2013, the availability will condense to five statewide plans and only three geographic regions, according to a press release from the Ohio Department of Job and Family Services (ODJFS).  The change is billed by Kasich's office as a way to simplify the way it offers coverage, eventually making a more sustainable, efficiently run program, which will supposedly trump the short-term inconveniences caused by the switch. According to The Enquirer, Medicaid costs the state of Ohio around $4.8 billion each year — nearly one fifth of the state’s budget. Those costs continue to grow. Bloomberg Businessweek reports that the new plan will also mandate higher care standards and offer financial incentives to doctors, hospitals and other providers to help improve care quality and patient health.Selected managed care organizations include: Aetna Better Health of Ohio, CareSource, Meridian Health Plan, Paramount Advantage and United Healthcare Community Plan of Ohio. Managed care organizations who lost the bid include incumbent providers Centene, AmeriGroup and Molina Healthcare, among others. According to the Wall Street Journal, the loss of business marks a blow for those providers, who have benefited from covering "dual-eligible" patients — those eligible for both Medicare and Medicaid services. WSJ reports that dual-eligible patients are seen as a $300 billion opportunity for managed care firms. Because Ohio is pushing to start better coordinating care for dual-eligible patients, dropped insurers will likely lose a piece of that pie. Streamlining the selection of managed care organizations available should help, in turn, streamline processes for dual-eligible patients, who often encounter difficultly in coordinating coverage with both Medicaid and Medicare services, says Jim Ashmore, performance improvement section chief for Hamilton County Department of Job and Family Services (HCJFS).ODJFS reports that the new providers were selected using a fair, through and open application process that was “based on applicants’ past performance in coordinating care and providing high-quality health outcomes.” Although the changes are generally perceived as a positive move forward, service providers, including doctors and health centers, acknowledge that the disruption in services could cause serious confusion when recipients are forced to find new providers and obtain new Medicaid cards. In Kentucky, the three private managed care companies which provided Medicaid services to more than 500,000 patients have received an influx of care-related complaints, including inefficiency in authorizing services and payment issues.  Ashmore challenges the notion that the transition will be a bumpy one, noting patients have little to worry about: When the transition is made, everyone will likely receive an enrollment package in the mail that will outline steps to switch over new care providers.