December 23, 2025 • 14 mins
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.
Resources:
- https://www.counseling.org/advocacy/take-action
- https://ohiocounseling.org/legislative-advocacy
- https://www.legislature.ohio.gov/legislation/status-reports
OCA Link Tree: https://linktr.ee/ohiocounseling
Stay in touch and join the conversation:
- Instagram: @OhioCounseling
- Facebook: facebook.com/ohiocounseling
- LinkedIn: https://www.linkedin.com/in/ohio-counseling-association-b78256165/
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
Mark as Played
Transcript
Episode Transcript
Available transcripts are automatically generated. Complete accuracy is not guaranteed.
SPEAKER_00 (00:01):
Welcome to Ohio Counseling Conversations Cat to
Capital, your quick connectionfrom the counseling office to
where laws meet lies.
In this segment, we break downthe latest legislative and
judicial updates, policychanges, and advocacy efforts
that impact counselors acrossOhio.
Whether you're licensed, intraining, or just passionate
(00:22):
about the field of counseling,we've got what you need to stay
informed and empowered.
SPEAKER_01 (00:29):
Hello, everyone, and welcome back to Couch to
Capital, a monthly segment ofOhio Counseling Conversations
that debuted in May of thisyear.
I'm Dr.
Chase Morgan Swainey, and I'mhonored to serve as
president-elect of the OhioCounseling Association.
Today's episode is our year-endrecap.
We're going to take a fastpractical lap through the major
(00:50):
counseling-relevant policythreads we tracked in Couch to
Capital this year.
And I'll also share where thingsstand right now, so you're not
left with yesterday's headlines.
Quick note before we jump inlegislation moves, committees
change, timelines shift, thecourts ensnare policies.
So think of this as yoursnapshot recap, plus clear next
(01:12):
steps if you want to stayengaged.
If I had to summarize this yearin three themes, it would be
first, access to care is stillan infrastructure problem.
That includes insurancebarriers, parity, workforce
pathways, telehealth rules, andthe reality that people can't
benefit from counseling theycan't afford or can't get to.
(01:33):
Second, higher education policymatters for the counseling
workforce pipeline.
We tracked major changes thataffect campuses, students, and
how future counselors aretrained and supported.
And lastly, culture war policyis not abstract.
It lands in our counselingspaces.
We discussed policies affectingLGBTQ clients, minors access to
(01:57):
sensitive information andservices more broadly, and the
chilling effects that ripplethrough families, schools, and
our communities.
So with those three themes inmind, here's our quick
month-to-month recap.
In May, our first big federalheadline was parity.
The Departments of Labor, Healthand Human Services, and Treasury
(02:17):
announced they would pauseenforcement of the 2024 Final
Rule for the Mental HealthParity and Addiction Equity Act.
Translation (02:24):
Parity is still the law, but the newer enforcement
muscle aimed at things likeprior authorization, network
adequacy, and step therapy gotput in limbo because of
litigation.
For counselors and clients, thatcan mean more denials, more
delays, and more time spentfighting systems instead of
doing and receiving care.
(02:46):
May also brought a verypractical issue: getting paid.
We broke down proposed changesrelated to electronic fund
transfers and how paymentmethods and fees can create very
real strain on practices andagencies.
Then we put a bright light onyouth access.
We tracked House Bill 172, whichwould repeal, if enacted, the
(03:06):
Ohio provision that currentlyallows minors in crisis to
access mental health serviceswithout parental consent for a
period of time.
We emphasize something critical.
These policies don't staytheoretical.
They shape whether youth reachout at all and whether
counselors can create conditionsfor safety.
As of now, House Bill 172 sitsin the health committee, where
(03:30):
it has received three hearings,including most recently an
opponent testimony hearing inwhich OCA submitted testimony
against the bill.
We also flagged House Bill 277,addressing how healthcare
workers using digital staffingplatforms could be classified as
independent contractors and whatthat might mean for parts of the
behavioral health workforce.
(03:51):
As of now, House Bill 277 sitsin the Commerce and Labor
Committee.
It has received one committeehearing since June.
So where do things stand now?
At the federal level, parityenforcement is still in a
complicated place due tolitigation and shifting
enforcement timelines.
So it's a watch closely area,not a set it and forget it area.
(04:13):
And in Ohio, several bills weflagged early in the year
largely remain in committeestatus, meaning advocacy and
education still matter becausecommittee rooms are often where
outcomes are decided.
June was Pride Month, and wetalked about how budget language
in the Ohio budget and relatedpolicy proposals can directly
(04:34):
affect LGBTQ youth and thecounselors who serve them.
We also had a bright spot wewant to name clearly.
Ohio's 988 Suicide and CrisisLifeline received an increase in
funding, set to take effect infiscal year 2026.
988 matters because it's oftenthe front door to life-saving
(04:54):
support and demand isincreasing.
And we zoomed out to the courts.
We discussed the United StatesSupreme Court's decision and
United States versus Skermettiand what it could signal
nationally.
And we connected that to Ohio'songoing legal and legislative
landscape, including House Bill68 and the related case Mo vs.
(05:15):
Yost.
July was a big month forbudgets, both state and
national.
In Ohio, Governor DeWine signedthe state budget on June 30th
and issued dozens of vetoes.
We walked through the vetoesthat mattered to counselors,
including items affectinglibraries, shelters serving
trans and non-binary youth, andrestrictions around flags on
(05:38):
state property.
At the same time, we made itclear some harmful provisions
still made it into the finalbudget, including measures that
reinforced a rigid binaryframing of sex and policies that
could affect coverage forgender-affirming care.
Even when a veto happens, theripple effects of what remains
land directly in our laps ascounselors.
(06:00):
Nationally, we covered HR one,the so-called one big beautiful
bill, and why Medicaid policy iscounseling policy.
We discussed how proposedMedicaid cuts can reduce access
to counseling for clients acrossOhio, especially rural
communities, and how changes toSNAP can amplify stress and
(06:20):
instability.
We also highlighted House Bill390, a pro-provider bill that
would shift responsibility forcollecting co-pays and
deductibles from providers toinsurers and require
reimbursement for coveredservices to be paid directly to
providers.
As of now, House Bill 390 sitsin the Insurance Committee,
(06:42):
where it has received onehearing since October.
August brought major counselingworkforce news.
Momentum continued to grow forthe Counseling Compact, and we
talked about what it can meanfor professional mobility and
continuity of care across statelines.
But August also brought seriousconcern.
We discussed SAMHSA's decisionto end specialized 988 support
(07:05):
for LGBTQ youth and whyaffirming specialized crisis
support is not extra.
It's life-saving.
We also covered the FederalTrade Commission, considering
whether to labelgender-affirming care an unfair
or deceptive practice, and weencourage counselors to submit
public comment.
Back in Ohio, we discussedballot initiatives related to
(07:27):
equal rights protections andhighlighted House Bill 415, the
Crown Act regardingdiscrimination based on hair,
because school climate is mentalhealth.
As of now, House Bill 415 sitsin the Education Committee,
where it has received threehearings, the most recent in
October.
And we covered a major nationalfunding hit.
(07:50):
The Department of Educationcanceling significant school
mental health funding under theBipartisan Safer Communities
Act.
At a time when youth mentalhealth needs are urgent, the
loss of those supports are realand they have downstream
consequences for students,families, and the professionals
trying to serve them.
So where do things stand?
The counseling compact continuesto grow across states, but past
(08:14):
is not the same as live.
Implementation details andtimelines matter a great deal.
As of now, only Arizona andMinnesota have gone live and can
issue practice privilegesthrough the compact.
Good news, all signs point toOhio being one of the next
states to go live.
Stay tuned for more informationfrom our licensure board.
(08:37):
September put the counselingpipeline front and center.
We discussed Senate Bill 1, theAdvanced Ohio Higher Education
Act, and how Ohio institutionswere beginning to respond,
including program eliminationstied to low enrollment
thresholds and new complianceexpectations.
We also stayed on telehealthbecause access does not begin
(08:59):
and end at a clinic door.
We talked about Congressconsidering a stopgap continuing
resolution, ultimately leadingto the most extended government
shutdown in American history, inthe importance of including
telemetal health flexibilitiesin the continuing resolution.
And we addressed a theme thatkept popping up this year:
(09:19):
misinformation.
We discussed political pushbackagainst school-based mental
health screenings and how stigmagrows when mental health stays
hidden.
We also discussed high-profilemisinformation around
reproductive health and autismbecause public narratives shape
clients' fears, shame, anddecision making long before they
step into our offices.
(09:40):
In October, our colleague MariahPayne took the mic and walked
listeners through the federalgovernment shutdown and the
real-time disruptions that canfollow, including changes to
telehealth waivers and billinguncertainty.
We also talked about the risk ofinterruptions to SNAP benefits
and why counselors may need toboost resource lists and
concrete supports.
(10:00):
October and November also keptyouth privacy on the radar.
We discussed House Bill 162, theMy Child My Chart Act, and why
confidentiality is often thecondition that makes adolescent
help seeking possible.
We emphasize the ethical andclinical implications, not just
the political debate.
(10:20):
Since then, House Bill 162passed the Ohio House and has
been assigned to the SenateHealth Committee, where it is
yet to receive any hearings.
We also discussed House Bill 324and the mental health impact of
reproductive restrictions.
Political decisions about bodilyautonomy can become political
trauma, and counselors are oftensupporting clients through the
(10:42):
anxiety and grief that follow.
As of now, House Bill 324 passedthe Ohio House and has been
introduced in the Senate.
It has yet to be assigned to acommittee.
And in November, we coveredHouse Bill 249 and how vague,
sweeping restrictions targetingLGBTQ communities can create
(11:02):
systemic stress that counselorsthen help clients carry.
As of now, House Bill 249 hasbeen assigned to the Judiciary
Committee, which has held twohearings on the legislation, the
most recent in October.
Finally, we ended the year on aworkforce issue that could
reshape the future ofcounseling.
(11:23):
Proposed federal student loancaps for nondoctorate graduate
programs beginning July 1st,2026.
If counseling students can'tafford to enter KRAP aligned
programs, that impacts theentire system.
Fewer counselors, longer waitlists, reduced access,
especially in rural andunderserved communities.
(11:45):
The American CounselingAssociation will submit comments
on these proposed changes to theDepartment of Education during
their public comment period,which is anticipated to begin in
early 2026.
You can act now.
Share how student loanssupported your journey to
becoming a licensed professionalcounselor and how the proposed
loan limits would negativelyimpact future students'
(12:07):
educational and professionaltrajectories.
Listeners can find the link toshare their stories with ACA in
the show notes for this episode.
So what do we carry into 2026?
Keep watching parity enforcementand insurer practices,
telehealth flexibilities, youthconfidentiality legislation,
(12:27):
policies that restrict affirmingcare, and anything that shrinks
the counseling workforce,including Medicaid policy and
student loan rules.
And remember, advocacy does nothave to be complicated.
Stay informed through OCAupdates.
Contact your legislators when abill affects your clients, and
connect with OCA when you want apath to get involved.
(12:49):
According to the AmericanCounseling Association, Ohio was
among the top five most activestates in responding to their
federal advocacy action alerts.
Let's keep it that way in 2026.
Thank you for spending this yearwith us on Couch to Capital.
If this recap was helpful, shareit with a colleague, subscribe
(13:11):
so you don't miss next month'supdates, and keep advocating.
Speaking of, stay tuned to OCAsocials for information about
our 2026 Legislative AdvocacyDay.
From the Ohio CounselingAssociation and Ohio Counseling
Conversations, take care ofyourselves, take care of each
other, and we'll see you in2026.
SPEAKER_00 (13:34):
That's it for this edition of Catch to Capital,
brought to you by the OhioCounseling Association and Ohio
Counseling Conversations.
In the meantime, stay tuned,stay engaged, and keep
advocating for the future ofcounsel in Ohio.
Because what happens at theCapitol doesn't stay at the
Capitol, it impacts everycounseling conversation.
Welcome to Ohio Counseling Conversations Cat to
Capital, your quick connectionfrom the counseling office to
where laws meet lies.
In this segment, we break downthe latest legislative and
judicial updates, policychanges, and advocacy efforts
that impact counselors acrossOhio.
Whether you're licensed, intraining, or just passionate
(00:22):
about the field of counseling,we've got what you need to stay
informed and empowered.
SPEAKER_01 (00:29):
Hello, everyone, and welcome back to Couch to
Capital, a monthly segment ofOhio Counseling Conversations
that debuted in May of thisyear.
I'm Dr.
Chase Morgan Swainey, and I'mhonored to serve as
president-elect of the OhioCounseling Association.
Today's episode is our year-endrecap.
We're going to take a fastpractical lap through the major
(00:50):
counseling-relevant policythreads we tracked in Couch to
Capital this year.
And I'll also share where thingsstand right now, so you're not
left with yesterday's headlines.
Quick note before we jump inlegislation moves, committees
change, timelines shift, thecourts ensnare policies.
So think of this as yoursnapshot recap, plus clear next
(01:12):
steps if you want to stayengaged.
If I had to summarize this yearin three themes, it would be
first, access to care is stillan infrastructure problem.
That includes insurancebarriers, parity, workforce
pathways, telehealth rules, andthe reality that people can't
benefit from counseling theycan't afford or can't get to.
(01:33):
Second, higher education policymatters for the counseling
workforce pipeline.
We tracked major changes thataffect campuses, students, and
how future counselors aretrained and supported.
And lastly, culture war policyis not abstract.
It lands in our counselingspaces.
We discussed policies affectingLGBTQ clients, minors access to
(01:57):
sensitive information andservices more broadly, and the
chilling effects that ripplethrough families, schools, and
our communities.
So with those three themes inmind, here's our quick
month-to-month recap.
In May, our first big federalheadline was parity.
The Departments of Labor, Healthand Human Services, and Treasury
(02:17):
announced they would pauseenforcement of the 2024 Final
Rule for the Mental HealthParity and Addiction Equity Act.
Translation (02:24):
Parity is still the law, but the newer enforcement
muscle aimed at things likeprior authorization, network
adequacy, and step therapy gotput in limbo because of
litigation.
For counselors and clients, thatcan mean more denials, more
delays, and more time spentfighting systems instead of
doing and receiving care.
(02:46):
May also brought a verypractical issue: getting paid.
We broke down proposed changesrelated to electronic fund
transfers and how paymentmethods and fees can create very
real strain on practices andagencies.
Then we put a bright light onyouth access.
We tracked House Bill 172, whichwould repeal, if enacted, the
(03:06):
Ohio provision that currentlyallows minors in crisis to
access mental health serviceswithout parental consent for a
period of time.
We emphasize something critical.
These policies don't staytheoretical.
They shape whether youth reachout at all and whether
counselors can create conditionsfor safety.
As of now, House Bill 172 sitsin the health committee, where
(03:30):
it has received three hearings,including most recently an
opponent testimony hearing inwhich OCA submitted testimony
against the bill.
We also flagged House Bill 277,addressing how healthcare
workers using digital staffingplatforms could be classified as
independent contractors and whatthat might mean for parts of the
behavioral health workforce.
(03:51):
As of now, House Bill 277 sitsin the Commerce and Labor
Committee.
It has received one committeehearing since June.
So where do things stand now?
At the federal level, parityenforcement is still in a
complicated place due tolitigation and shifting
enforcement timelines.
So it's a watch closely area,not a set it and forget it area.
(04:13):
And in Ohio, several bills weflagged early in the year
largely remain in committeestatus, meaning advocacy and
education still matter becausecommittee rooms are often where
outcomes are decided.
June was Pride Month, and wetalked about how budget language
in the Ohio budget and relatedpolicy proposals can directly
(04:34):
affect LGBTQ youth and thecounselors who serve them.
We also had a bright spot wewant to name clearly.
Ohio's 988 Suicide and CrisisLifeline received an increase in
funding, set to take effect infiscal year 2026.
988 matters because it's oftenthe front door to life-saving
(04:54):
support and demand isincreasing.
And we zoomed out to the courts.
We discussed the United StatesSupreme Court's decision and
United States versus Skermettiand what it could signal
nationally.
And we connected that to Ohio'songoing legal and legislative
landscape, including House Bill68 and the related case Mo vs.
(05:15):
Yost.
July was a big month forbudgets, both state and
national.
In Ohio, Governor DeWine signedthe state budget on June 30th
and issued dozens of vetoes.
We walked through the vetoesthat mattered to counselors,
including items affectinglibraries, shelters serving
trans and non-binary youth, andrestrictions around flags on
(05:38):
state property.
At the same time, we made itclear some harmful provisions
still made it into the finalbudget, including measures that
reinforced a rigid binaryframing of sex and policies that
could affect coverage forgender-affirming care.
Even when a veto happens, theripple effects of what remains
land directly in our laps ascounselors.
(06:00):
Nationally, we covered HR one,the so-called one big beautiful
bill, and why Medicaid policy iscounseling policy.
We discussed how proposedMedicaid cuts can reduce access
to counseling for clients acrossOhio, especially rural
communities, and how changes toSNAP can amplify stress and
(06:20):
instability.
We also highlighted House Bill390, a pro-provider bill that
would shift responsibility forcollecting co-pays and
deductibles from providers toinsurers and require
reimbursement for coveredservices to be paid directly to
providers.
As of now, House Bill 390 sitsin the Insurance Committee,
(06:42):
where it has received onehearing since October.
August brought major counselingworkforce news.
Momentum continued to grow forthe Counseling Compact, and we
talked about what it can meanfor professional mobility and
continuity of care across statelines.
But August also brought seriousconcern.
We discussed SAMHSA's decisionto end specialized 988 support
(07:05):
for LGBTQ youth and whyaffirming specialized crisis
support is not extra.
It's life-saving.
We also covered the FederalTrade Commission, considering
whether to labelgender-affirming care an unfair
or deceptive practice, and weencourage counselors to submit
public comment.
Back in Ohio, we discussedballot initiatives related to
(07:27):
equal rights protections andhighlighted House Bill 415, the
Crown Act regardingdiscrimination based on hair,
because school climate is mentalhealth.
As of now, House Bill 415 sitsin the Education Committee,
where it has received threehearings, the most recent in
October.
And we covered a major nationalfunding hit.
(07:50):
The Department of Educationcanceling significant school
mental health funding under theBipartisan Safer Communities
Act.
At a time when youth mentalhealth needs are urgent, the
loss of those supports are realand they have downstream
consequences for students,families, and the professionals
trying to serve them.
So where do things stand?
The counseling compact continuesto grow across states, but past
(08:14):
is not the same as live.
Implementation details andtimelines matter a great deal.
As of now, only Arizona andMinnesota have gone live and can
issue practice privilegesthrough the compact.
Good news, all signs point toOhio being one of the next
states to go live.
Stay tuned for more informationfrom our licensure board.
(08:37):
September put the counselingpipeline front and center.
We discussed Senate Bill 1, theAdvanced Ohio Higher Education
Act, and how Ohio institutionswere beginning to respond,
including program eliminationstied to low enrollment
thresholds and new complianceexpectations.
We also stayed on telehealthbecause access does not begin
(08:59):
and end at a clinic door.
We talked about Congressconsidering a stopgap continuing
resolution, ultimately leadingto the most extended government
shutdown in American history, inthe importance of including
telemetal health flexibilitiesin the continuing resolution.
And we addressed a theme thatkept popping up this year:
(09:19):
misinformation.
We discussed political pushbackagainst school-based mental
health screenings and how stigmagrows when mental health stays
hidden.
We also discussed high-profilemisinformation around
reproductive health and autismbecause public narratives shape
clients' fears, shame, anddecision making long before they
step into our offices.
(09:40):
In October, our colleague MariahPayne took the mic and walked
listeners through the federalgovernment shutdown and the
real-time disruptions that canfollow, including changes to
telehealth waivers and billinguncertainty.
We also talked about the risk ofinterruptions to SNAP benefits
and why counselors may need toboost resource lists and
concrete supports.
(10:00):
October and November also keptyouth privacy on the radar.
We discussed House Bill 162, theMy Child My Chart Act, and why
confidentiality is often thecondition that makes adolescent
help seeking possible.
We emphasize the ethical andclinical implications, not just
the political debate.
(10:20):
Since then, House Bill 162passed the Ohio House and has
been assigned to the SenateHealth Committee, where it is
yet to receive any hearings.
We also discussed House Bill 324and the mental health impact of
reproductive restrictions.
Political decisions about bodilyautonomy can become political
trauma, and counselors are oftensupporting clients through the
(10:42):
anxiety and grief that follow.
As of now, House Bill 324 passedthe Ohio House and has been
introduced in the Senate.
It has yet to be assigned to acommittee.
And in November, we coveredHouse Bill 249 and how vague,
sweeping restrictions targetingLGBTQ communities can create
(11:02):
systemic stress that counselorsthen help clients carry.
As of now, House Bill 249 hasbeen assigned to the Judiciary
Committee, which has held twohearings on the legislation, the
most recent in October.
Finally, we ended the year on aworkforce issue that could
reshape the future ofcounseling.
(11:23):
Proposed federal student loancaps for nondoctorate graduate
programs beginning July 1st,2026.
If counseling students can'tafford to enter KRAP aligned
programs, that impacts theentire system.
Fewer counselors, longer waitlists, reduced access,
especially in rural andunderserved communities.
(11:45):
The American CounselingAssociation will submit comments
on these proposed changes to theDepartment of Education during
their public comment period,which is anticipated to begin in
early 2026.
You can act now.
Share how student loanssupported your journey to
becoming a licensed professionalcounselor and how the proposed
loan limits would negativelyimpact future students'
(12:07):
educational and professionaltrajectories.
Listeners can find the link toshare their stories with ACA in
the show notes for this episode.
So what do we carry into 2026?
Keep watching parity enforcementand insurer practices,
telehealth flexibilities, youthconfidentiality legislation,
(12:27):
policies that restrict affirmingcare, and anything that shrinks
the counseling workforce,including Medicaid policy and
student loan rules.
And remember, advocacy does nothave to be complicated.
Stay informed through OCAupdates.
Contact your legislators when abill affects your clients, and
connect with OCA when you want apath to get involved.
(12:49):
According to the AmericanCounseling Association, Ohio was
among the top five most activestates in responding to their
federal advocacy action alerts.
Let's keep it that way in 2026.
Thank you for spending this yearwith us on Couch to Capital.
If this recap was helpful, shareit with a colleague, subscribe
(13:11):
so you don't miss next month'supdates, and keep advocating.
Speaking of, stay tuned to OCAsocials for information about
our 2026 Legislative AdvocacyDay.
From the Ohio CounselingAssociation and Ohio Counseling
Conversations, take care ofyourselves, take care of each
other, and we'll see you in2026.
SPEAKER_00 (13:34):
That's it for this edition of Catch to Capital,
brought to you by the OhioCounseling Association and Ohio
Counseling Conversations.
In the meantime, stay tuned,stay engaged, and keep
advocating for the future ofcounsel in Ohio.
Because what happens at theCapitol doesn't stay at the
Capitol, it impacts everycounseling conversation.
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