Voters in 37 states will have more than candidates to choose in Tuesday’s election. There are more than 150 statewide measures on ballots this midterm election, and several involve health-related issues such as Medicaid expansion, marijuana, abortion, grocery taxes and charges related to drug use and possession.
Alabama, Oregon and West Virginia have measures that are aimed at restricting abortion access. If passed, Alabama’s Amendment 2 will add language to the state Constitution to give a fetus the same rights as a human who has been born.
Abortion-rights supporters in Alabama worry that the amendment could be used to criminalize some forms of in-vitro fertilization and contraception. There are also concerns that should the US Supreme Court end Roe v. Wade, this amendment would be a “trigger ban,” meaning abortion would be outlawed in the state.
This “personhood” ballot measure doesn’t have exemptions like in other states’ laws that carve out the right to an abortion in cases of rape, incest or the danger to the life of the mother.
Oregon’s Measure 106 would end state funding for abortions. Women who are public employees or who are on Medicaid would no longer get coverage for the procedure. There are exceptions for rape, incest, and a pregnancy that is a threat to the woman’s health.
West Virginia’s Amendment 1, also known as the No Constitutional Right to Abortion Amendment, would explicitly state that its Constitution has nothing in it that “secures or protects a right to abortion or requires the funding of abortion.” It also has an exception for rape, incest, fetal anomaly or threats to the woman’s life. It would essentially restrict Medicaid funding for abortions.
Voters in four states will have to decide how they feel about marijuana. In Michigan and North Dakota, they will consider whether recreational use should be legal for adults over 21. North Dakota’s amendment would also automatically expunge the record of someone who had a conviction related to weed.
Other states’ weed-related initiatives focus on medical marijuana; 31 states and the District of Columbia have laws that legalize or decriminalize it.
Missouri has three medical marijuana initiatives on the ballot this year. Amendment 2 would legalize medical marijuana, tax it at 4% and guarantee that the money would be spent on health care services for veterans. Amendment 3 also would legalize it for medical reasons and tax it at 15%, and the money would have to be spent to create a Biomedical Research and Drug Development Institute, a state-run institution that would look for cures for disease. The money that the drugs would earn would go back to the state.
Proposition C, a separate ballot question, would also legalize medical marijuana and tax it at 2%, and the money would have to go toward veterans, drug treatment, education and law enforcement. If voters say yes to all three, the one that gets the “largest affirmative vote shall prevail.”
In Utah, if voters say yes to Proposition 2, individuals with qualifying illnesses would get access to medical marijuana.
Montana, Idaho, Nebraska and Utah will consider expanding Medicaid. Montana’s I-185 would also raise taxes on tobacco products to help fund the expansion and other health care programs.
Idaho’s Proposition 2 would expand Medicaid eligibility to people under 65 whose income is 138% of the federal poverty level, as would Nebraska’s Initiative 427 and Utah’s Proposition 3. In Utah, that expansion would be funded in part by a sales tax increase.
There may be additional election-related changes with Medicaid. If Democrats win in Georgia, Kansas, Oklahoma, South Dakota, Wisconsin and Florida, there’s a possibility those states could expand Medicaid as well. In Florida alone, a million people would get health care coverage if Medicare is expanded in that state. Potentially, 2.7 million additional Americans could get coverage if elections go Democrats way in those states.
In Montana, the ballot question could end the Medicaid expansion there. The Tobacco industry has spent millions in the state to fight the initiative since it would double the cigarette task to pay for the state’s portion of Medicaid expansion.
Other health care initiatives are on the ballot in California, Massachusetts, Maine and Nevada.
California’s Proposition 4 would authorize $1.5 billion in bonds for children’s hospitals. Proposition 8 would require dialysis clinics to refund patients for revenue above 115% of the costs of direct patient care. Supporters of the initiative believe this would incentivize clinics to spend money on health care improvements rather than putting it toward their profits.
Proposition 11 would require people who work on ambulances to stay on call during breaks and require employers to give EMTs and paramedics additional training and some paid mental health services.
Question 1 in Massachusetts would limit the number of patients assigned to registered nurses working in a hospital. The state has such restrictions for intensive care units but not for any other part of the hospital.
Nevada’s Question 4 would require the state legislature to remove taxes on durable medical equipment, oxygen equipment and mobility devices that are prescribed by a licensed provider.
Other health matters
In Massachusetts, with Question 3, voters will decide whether they want to keep a law that prohibits discrimination based on gender identity in public places like restaurants, stores, hotels and hospitals. There’s no federal law that provides such protections. Without them, supporters of the ballot question say, people who identify as transgender could be denied access to doctors’ offices, hospitals and other medical care.
Some of the other ballot initiatives involve tax collection. In Nevada, Question 2 would exempt feminine hygiene products from sales tax. Oregon’s Measure 103 would ban taxes on groceries. Washington state has a similar initiative that would ban local governments from collecting taxes on groceries. The initiatives are getting broad support from soda companies like Coca-Cola and PepsiCo, Inc that see it as a way to fight the growing movement toward soda taxes.
South Dakota’s Initiated Measure 25 would increase taxes on tobacco products. Virginia’s Question 2 would remove a restriction on tax exemption for the surviving spouse of a disabled veteran. Maine’s Question 1 would create a payroll tax and non-wage income tax that would fund a home health care program.
In New Mexico, Bond Question A would provide $10.77 million in bonds for senior citizen facilities.
Ohio will vote on Issue 1, which would eliminate the option for a felony charge for the possession or use of drugs, would require the state to spend on programs that would include helping people get into drug treatment and rehabilitation programs, would create sentencing programs that involve drug rehab, and would prohibit courts from sending a person to prison for non-criminal probation violations.
Oklahoma voters will decide State Question 793, which would allow optometrists and opticians to practice in retail establishments.