Kaiser Daily Health Policy Report Highlights Results of Health-Related Ballot Measures

The Kaiser Daily Health Policy Report reports on the results of a number of health-related state ballot measures that voters considered Nov. 5 at the polls. Summaries of the results listed by state appear below:

Arizona

• Proposition 203: The measure, which would have established a registry to allow state residents with a chronic illness and a recommendation from a physician to use marijuana to treat pain, failed by a "wide margin," the Arizona Republic reports (Baker/Nichols, Arizona Republic, 11/6). The measure failed 57% to 43%, with 100% of precincts reporting (CNN.com, 11/6). Under the measure, the state Department of Health Services would have issued registry identification cards to residents ages 18 and older who qualify, and the state Department of Public Safety would have distributed as many as two ounces of medical marijuana to residents with the cards (Barrios, Arizona Daily Star, 10/15). The People Have Spoken, a group that supports the legalization of medical marijuana, sponsored the measure (Rushlo, Associated Press, 10/25). A coalition of county attorneys, sheriffs and pharmacists opposed the measure (Arizona Daily Star, 10/15). Federal officials also opposed the measure. Bruce Mirkin, a spokesperson for the Marijuana Policy Project, which supported the measure, said, "For the first time, we were up against the full weight of the federal government. I never for a moment believed this was going to be easy" (Crary, AP/Houston Chronicle, 11/6).



• Proposition 303: The measure, which will increase the state tax on tobacco products to fund emergency and trauma care services, passed by a 2-to-1 margin, the Arizona Republic reports (Arizona Republic, 11/6). The measure will increase the state tax on tobacco products by 60 cents, to $1.18 per pack. Under the measure, the state will use revenue from the tax to fund research and health coverage for families through the Arizona Health Care Cost Containment System, the state's Medicaid program. State officials expect that the measure to raise about $151 million in additional revenue each year (Kaiser Daily Health Policy Report, 5/16). Bill Pfeifer, president and CEO of the American Lung Association of Arizona/New Mexico, said, "It's a sense of relief that we won." He added, "Now the real work begins. We need to be responsible in collecting the money and delivering it back to the people" (Arizona Republic, 11/6).

Arkansas

• Amendment 3: The measure, which would have amended the Arkansas constitution to prohibit taxation of medicine or food products, failed, the Associated Press reports (Associated Press, 11/6). The Axe the Food Tax Committee sponsored the measure. Opponents, such as Arkansans to Protect Police, Libraries, Education and Services, have said that the measure would result in a loss of $345 million in state revenue and could lead to reductions in hospital and other services and state programs such as Medicaid (Jefferson, AP/Memphis Commercial Appeal, 10/25).

Colorado

• Referendum B: The measure, which would have amended the Colorado constitution to allow local governments to become a subscriber, member, shareholder or part owner in public or private companies to provide health care services and not incur debt, failed by a 59% to 41% margin, the Denver Rocky Mountain News reports (Denver Rocky Mountain News, 11/6). According to the state Legislature, which sponsored Referendum B, the measure could have helped expand health care services in some communities and provide additional revenue to maintain facilities (Colorado Springs Gazette, 10/20). The Colorado Health and Hospital Association also supported the measure. No organized group opposes Referendum B, but opponents said that the measure would place public funds at risk (Perrault, Denver Rocky Mountain News, 10/23).

Florida

• Amendment 6: The measure, which will prohibit smoking in most enclosed indoor workplaces in the state, passed by a 71% to 29% margin, with 98% of precincts reporting, CNN.com reports (CNN.com, 11/6). Florida will become the first Southeast state to ban smoking in the workplace when the measure takes effect next year (Filaroski, Florida Times-Union, 11/6). The ban will not include private residences, except those used to provide commercial child care, adult care or health care services. The measure also will allow smoking in retail tobacco stores, designated hotel rooms and bars not attached to restaurants. Smoke-Free for Health, an advocacy group established by the American Cancer Society, the American Lung Association and the American Heart Association, sponsored the measure (Hallifax, AP/Tallahassee Democrat, 10/30). The AARP of Florida and the Center for Florida's Children supported Amendment 6; tobacco companies opposed the measure (Kinsler/Steele, Tampa Tribune, 10/23).

Michigan

• Proposal 4: The measure, which would have required Michigan to spend part of the state's annual share of the national tobacco settlement on health care, failed by a 2-to-1 margin, with 64% of precincts reporting, the Detroit Free Press reports (Montemurri, Detroit Free Press, 11/6). The measure would have amended the state constitution to require Michigan to spend 90% of the state's $297 million annual share of the national tobacco settlement on health care (Kaiser Daily Health Policy Report, 10/30). Under Proposal 4, the state would have spent: $151.8 million per year on not-for-profit hospitals, licensed nursing homes, licensed hospices, nurse practitioners, school-based health centers and the Healthy Michigan Foundation; $102.3 million on anti-tobacco programs, the Health and Aging Research Development Initiative, the Tobacco-Free Futures Fund, the Council of Michigan Foundations and the Nurses Scholarship Program; and $42.9 million on the Elder Prescription Drug Program (Michigan Electronic Voter Guide). Citizens for Healthy Michigan, which sponsored Proposal 4, and the Michigan Health and Hospital Association supported the measure. People Protecting Kids and the Constitution opposed the measure. In addition, Detroit Medical Center and some other large health systems in the state opposed the measure, which they maintained favors high-revenue hospitals over those that treat a higher percentage of low-income patients (Montemurri, Detroit Free Press, 10/29). Supporters of the measure promised to continue efforts to shift the state's tobacco settlement funds to health care (Bebow, Detroit News, 11/6). Jim Moore of the American Lung Association, said, "The difficulty voters had was with the constitutional issues rather than whether dollars should go to reduce the devastating effects that tobacco has on the people" of Michigan (Detroit Free Press, 11/6).

Missouri

• Proposition A: The measure, which would have increased the state's tax on cigarettes and other tobacco products, failed by a 51% to 49% margin, with 95% of precincts reporting, the Kansas City Star reports (Hoover, Kansas City Star, 11/6). The measure, sponsored by Citizens for a Healthy Missouri, would have increased the state's tax on cigarettes by 55 cents to 72 cents per pack and raised the state's tax on other tobacco products by 20%. State officials expected that the measure would have generated about $342.6 million in additional revenue each year. Under the measure, the state would have spent 43% of the revenue raised on health care programs, such as prescription drug coverage for seniors and programs for low-income residents, women, minorities and children; 29% on emergency and trauma care; 14% for medical research; 7% on tobacco prevention programs; and 7% on grants for early childhood care and education. According to supporters, which included providers, business groups, health care organizations and Gov. Bob Holden (D), the measure would have decreased teenage smoking rates in the state and provided funds for a number of health care programs. Opponents criticized the large percentage of funds that the measure would have provided for hospitals and other providers and the small percentage that the measure would have provided for tobacco prevention programs (Hoover, Kansas City Star, 10/30).

Montana

• Initiative 146: The measure, which will require Montana to spend part of the state's $30 million annual share of the national tobacco settlement on tobacco prevention and health care programs, passed, the Associated Press reports (Associated Press, 11/6). The measure will require Montana to spend 32% of the state's $30 million annual share of the national tobacco settlement to administer tobacco prevention programs and 17% to increase funds for the state's CHIP program and the Montana Comprehensive Health Association, which provides health coverage for high-risk adults (Laceky, Associated Press, 10/21).

Ohio

• Issue One: The measure, which would have required the state to place some drug offenders in treatment programs, rather than in prison, failed by a 67% to 33% margin, with 99% of precincts reporting (CNN.com, 11/6). The measure would have amended the Ohio constitution to require the state to place nonviolent first- and second-time drug offenders in treatment programs, rather than in prison, at their request. After completion of a 12- or 18-month treatment program, the state could have removed an offender's conviction from court records (Associated Press, 10/15). The measure would have required the state to spend $247 million to administer the program for six years. Supporters maintain that the measure would have saved the state a net $21.3 million per year. However, according to opponents, the amount that the measure would have saved in incarceration costs would not have offset the additional expenditures for treatment programs (Eckert, Dayton Daily News, 10/30). Opponents, such as White House Office of National Drug Control Policy Director John Walters, also maintained that the state should allow judges to decide whether drug offenders receive treatment rather than prison sentences (Eckert, Dayton Daily News, 10/17).

Oklahoma

• State Question 701: The measure, which would have amended the Oklahoma constitution to revise expenditures from the state Tobacco Settlement Endowment Trust Fund, failed by a 55% to 45% margin, with 100% of precincts reporting, the Daily Oklahoman reports (Daily Oklahoman, 11/6). Under the measure, the state would have based expenditures on the average market value of the fund, rather than on annual earnings. The amount spent, which the Board of Investors determines, could not have exceeded 5.5% of the total value of the fund (Daily Oklahoman, 10/27). The measure also would have allowed the state to use the fund to pay outside vendors and for financial management services, rather than only for tobacco prevention, health care, cancer treatment and education programs (Price, Oklahoma City Journal Record, 10/15). State Treasurer Robert Butkin (D) and other financial analysts supported the measure, which they maintained would have resulted in more consistent fund expenditures for a number of state programs (Krehbiel, Tulsa World, 10/21).

Oregon

• Measure 23: The measure, which would have required the state to implement a universal health care system, failed by a 79% to 21% margin, with 76% of precincts reporting, CNN.com reports (CNN.com, 11/6). The measure would have required the state to implement a system that covered "medically necessary" health services, such as preventive care, prescription drugs, long-term care and alternative care, by 2005. A new state agency, called the Oregon Comprehensive Health Care Finance Board, which would have included two members from each congressional district and five members appointed by the governor, would have administered the system. Businesses would have paid a new payroll tax of as much as 11.5%, and personal income tax rates would have increased from 9% to as much as 17%. State officials estimated that the measure would have cost about $19 billion per year (Kaiser Daily Health Policy Report, 10/29). Health Care for All Oregon sponsored the measure. Business groups, private health plans and the Oregon Medical Association opposed the measure (American Health Line, 9/25). The New York Times reports that voters appeared "receptive to the arguments that the proposal was too costly or was likely to harm employers or drive doctors from the state (Marquis, New York Times, 11/6). NBC's "Nightly News" yesterday reported on Measure 23 (O'Neil, "Nightly News," NBC, 11/5). A video excerpt of the segment is available in RealPlayer at online. PRI's "Marketplace" yesterday also reported on the measure (Tripoli, "Marketplace," PRI, 11/5). A transcript of the segment is available online. In addition, the full segment is available in RealPlayer at online.