Kaiser Daily Health Policy Report Profiles Health-Related Ballot Measures Under Consideration in Eight States
The Kaiser Daily Health Policy Report highlights a number of the health-related state ballot measures that voters will consider on Election Day. Summaries of the measures listed by state appear below.
California
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Proposition 61: The measure, proposed by a coalition of children's hospitals, would provide through the issue of state bonds $750 million to cover the cost of construction, expansion and equipment for children's hospitals. The measure, with interest, would cost the state about $1.5 billion over 30 years. Supporters, such as the California Nurses Association and the California Parent Teacher Association, maintain that the measure would provide children's hospitals with necessary funds as health care costs increase. However, according to opponents, such as anti-tax groups, the measure would not guarantee that the funds would lead to expanded health care for children (Los Angeles Times, 10/24).
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Proposition 63: The measure, proposed by the Campaign for Mental Health, would increase taxes by 1% for state residents with taxable annual incomes of more than $1 million to fund new county mental health programs and expand current programs. The measure, which would take effect on Jan. 1, 2005, would increase taxes for between 25,000 and 30,000 state residents and would raise more than $600 million in additional revenue annually. The programs involved in the measure would use the funds to provide mental health services for low-income residents without health insurance, expand preventive mental health treatment, add staff at mental health facilities and provide services for families of children with mental illnesses. According to supporters, such as California Assembly Budget Committee Chair Darrell Steinberg (D), the measure would allow the state to meet promises to provide adequate funds for county mental health programs. Opponents -- such as Citizens for a Healthy Economy, the Howard Jarvis Taxpayers Association, the California Chamber of Commerce and other anti-tax and business groups -- maintain that the measure would prompt businesses to leave the state (Los Angeles Times, 10/5).
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Proposition 67: The measure, proposed by the Coalition to Preserve Emergency Care, would place a 3% surcharge on telephone bills to fund emergency medical services for state residents. The measure would cap the surcharge for residential telephone lines at 50 cents monthly but would not cap the surcharge for cellular and business telephone lines. Under the measure, which would raise about $500 million in additional revenue annually, the state would use the funds to help finance county trauma centers -- many of which have closed in recent years because of an increased number of uninsured patients -- improve the 911 phone system and train firefighters and paramedics. The California Medical Association and the California Primary Care Association support the measure. According to opponents, such as anti-tax and business groups, the measure would harm small businesses and the state economy (Los Angeles Times, 10/5).
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Proposition 71: The measure, proposed by the advocacy group California Stem Cell Research & Cures Initiative, would raise an average of $295 million annually for 10 years to promote stem cell research through the issue of state bonds (Hall, San Francisco
Chronicle, 6/4). The measure would provide funds for a new stem cell research center at a University of California campus, as well as grants and loans for laboratory projects at other universities and colleges. The measure, with interest, would cost a total of $6 billion (Krieger, San Jose Mercury News, 4/17). Under the measure, a 29-member citizen oversight commission appointed by the governor and state lawmakers would distribute the funds (Ingram/Rau, Los Angeles Times, 6/4). The measure would delay repayment from the bond principal and interest for five years (Krieger, San Jose Mercury News, 6/4). The measure also would prohibit research that involves human cloning and certain other forms of cloning According to supporters -- such as a number of scientists, research facilities and disease and patient advocacy groups -- the measure could lead to new treatments for a number of diseases, as well as new jobs and increased tax revenue for the state (San Francisco Chronicle, 6/4). However, some opponents, such as the Catholic Church, have raised ethical concerns about embryonic stem cell research that the measure would fund (San Jose Mercury News, 6/4). Other opponents have raised financial concerns (San Francisco Chronicle).
- Proposition 72: The measure will allow California residents to vote to "yes" to uphold or "no" to repeal a new state law (SB 2) that would require certain employers to provide health insurance to workers or pay into a state fund to provide such coverage (Kaiser Daily Health Policy Report, 10/25). SB 2, scheduled to take effect on Jan. 1, 2006, would require employers with 200 or more employees to provide health insurance to workers and their dependents by 2006 or pay into the state fund. Employers with between 50 and 199 employees would have to provide health insurance to workers only by 2007. Employers with fewer than 20 employees would not have to comply with SB 2, and the law also would exempt employers with between 20 and 49 employees unless the state provides them with tax credits to offset the cost of health insurance (Kaiser Daily Health Policy Report, 10/6/03). Supporters of SB 2, such as members of CMA and consumer and labor groups, maintain that the law would help address the issues of the uninsured and increased health care costs for workers. However, according to opponents of SB 2, such as the California Restaurant Association and other business groups, the law would prompt many employers to leave the state, and the exemptions for smaller employers would place larger employers at a competitive disadvantage (Rau, Los Angeles Times, 10/16).
Colorado
- Amendment 35: The measure, supported by health professionals and advocates for children, would amend the Colorado constitution to increase the state cigarette tax from 20 cents to 84 cents per pack and double the state tax on other tobacco products. The measure would raise an estimated $175 million in additional revenue annually. Under the measure, the state would spend 46% of the funds on Child Health Plan Plus, the state SCHIP program, and the state Medicaid program; 19% for community health centers; 16% on programs to detect and treat smoking-related illnesses, such as cancer and heart disease; 16% on anti-smoking programs; and 3% to help county and municipal governments offset lost revenue from lower tobacco product sales and fund their health care programs. Opponents of the measure, such as tobacco distributors, maintain that Colorado should enact any increase in state taxes on cigarettes or other tobacco products as legislation, rather than as an amendment to the state constitution (Olinger, Denver Post, 10/17).
Florida
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Amendment 1: The measure, proposed by the Florida Legislature, would amend the state constitution to allow state lawmakers to require minor girls to obtain parental notification before they can receive an abortion. Under the measure, state lawmakers must provide exceptions to the parental notification requirement and establish a process for judicial waiver of the requirement. Supporters proposed the measure after the Florida Supreme Court in 2003 ruled that a state parental notification law, which was enacted in 1999 but never implemented because of legal challenges, violated the state constitution. According to supporters, such as the Florida Catholic Conference, the measure would allow parents to become more involved in the decisions of their children. However, opponents, such as the American Civil Liberties Union of Florida and Planned Parenthood Federation of America affiliates in the state, maintain that the measure could endanger minor girls who are afraid to inform their parents that they are pregnant (Hallifax, AP/Bradenton Herald, 8/17).
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Amendment 3: The measure -- proposed by Citizens for a Fair Share, a political action committee of the Florida Medical Association -- would amend the state constitution to allow plaintiffs in medical malpractice lawsuits to retain 70% of the first $250,000 in damages awarded and 90% of damages awarded in excess of that amount. Floridians for Patient Protection, which represents trial attorneys, opposes the measure (Kaiser Daily Health Policy Report, 7/16). Supporters maintain that the measure would decrease the number of malpractice lawsuits filed in the state and lead to reduced malpractice insurance premiums. However, according to opponents, the measure would limit the ability of patients who experience malpractice to hire attorneys to represent them in lawsuits (Ballot Initiative Strategy Center, "Qualified Ballot Measures," July 2004).
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Amendment 7: The measure, proposed by FPP, would amend the state constitution to allow patients to examine records of medical errors that cause harm to patients committed by physicians in medical facilities. FMA opposes the measure (Kaiser Daily Health Policy Report, 7/16).
- Amendment 8: The measure, proposed by FPP, would amend the state constitution to allow the revocation of the licenses of physicians who lose three malpractice lawsuits. The measure would not apply to malpractice settlements and would apply retroactively. FPP maintains that the measure would affect few physicians in the state. However, according to opponents, such as FMA, the measure would force physicians to settle malpractice lawsuits to avoid the risk of losses in trials and could prompt physicians in high-risk specialties to leave the state (Kaiser Daily Health Policy Report, 7/23).
Montana
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Initiative 148: The measure, proposed by the Montana chapter of the Marijuana Policy Project, would allow state residents with chronic illnesses to grow, possess and use limited amounts of marijuana for medical purposes. In addition, the measure would protect patients and their physicians and caregivers from arrest and prosecution. According to supporters, marijuana can help treat pain, nausea and other symptoms associated with AIDS, cancer, multiple sclerosis, glaucoma and other chronic illnesses. However, opponents, such as the White House Office of National Drug Control Policy, maintain that the measure could lead to the complete legalization of marijuana and raise concerns about potential problems with abuse and enforcement.
- Initiative 149: The measure, proposed by a coalition of 20 advocacy groups, would increase the state tax on cigarettes from 70 cents to $1.70 per pack, the state tax on chewing tobacco from 35 cents to 85 cents per ounce and the state tax on other tobacco products from 25% to 50% of the wholesale price. The measure, which would take effect on Jan. 1, 2005, would raise an estimated $45 million in additional revenue annually. Under the measure, the state would spend most of the funds on current or new health care programs. Supporters maintain that the measure would reduce youth smoking and provide funds for important health care programs. However, according to opponents -- such as veteran groups, tobacco distributors, tobacco companies and convenience store owners -- the measure is unconstitutional and could prompt state residents to purchase lower-priced tobacco products illegally (Cooke, Associated Press, 10/18).
Nevada
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Question 3: The measure, supported by physician groups, would eliminate exceptions to the current $350,000 state cap on noneconomic damages in medical malpractice lawsuits. In addition, the measure would revise the payment policy for damage awards in malpractice lawsuits filed against multiple defendants to make individual health care providers responsible only for their shares of such awards. The measure also would cap attorney fees and administrative costs in malpractice lawsuits, allow juries to have information on the annual incomes of plaintiffs and provide judges with the authority to decide whether defendants should pay damage awards in one lump sum or over time. (Kaiser Daily Health Policy Report, 9/24). Supporters maintain that without the measure, physicians would leave the state to avoid high malpractice insurance premiums (Harasim, Las Vegas Review-Journal, 10/14). The Nevada Trial Lawyers Association, which opposes the measure, denies the claim (Ballot Initiative Strategy Center, "Qualified Ballot Measures," July 2004). Opponents also maintain that the measure would provide unfair legal protections to malpractice insurers and physicians accused of malpractice (Las Vegas Review-Journal, 10/14).
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Question 4: The measure, supported by trial attorney groups, calls for a 20% decrease in medical malpractice insurance premium rates and the elimination of the state cap on noneconomic damages in malpractice lawsuits in the event rates are not reduced by at least 10% within one year (Kaiser Daily Health Policy Report, 9/24). The Nevada State Medical Association and other physician groups oppose the measure (Kaiser Daily Health Policy Report, 9/10).
- Question 5: The measure, supported by trial attorney groups, would fine attorneys who file frivolous medical malpractice lawsuits (Kaiser Daily Health Policy Report, 9/24). NSMA and other physician groups oppose the measure (Kaiser Daily Health Policy Report, 9/10).
Oklahoma
- State Question 713: The measure, supported by health care advocacy groups and Gov. Brad Henry (D), would increase the state cigarette tax by 55 cents per pack and raise the state tax on other tobacco products. The measure, which would take effect on Jan. 1, 2005, would raise an estimated $150 million in additional revenue annually. Under the measure, the state would use the funds to help cover the cost of health insurance premiums for uninsured residents, offset reductions in Medicaid reimbursements, reimburse hospitals statewide for trauma care, improve telemedicine in rural areas and help establish a cancer center operated by the University of Oklahoma. The measure also would reduce the state capital gains tax, decrease taxes for retirees and reduce the maximum state income tax rate from 7% to 6.65%. Supporters maintain that the measure would reduce youth smoking and provide funds for important health care programs. However, according to opponents -- such as the Tobacco Retailers Alliance, which represents tobacco retailers and others -- the measure is unfair and would force retailers to raise prices on other products. In addition, opponents maintain that the measure could lead to a reduction in the state smoking rate, which would decrease funds for health care programs in the long term (Kurt, Associated Press, 10/11).
Oregon
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Measure 33: The measure would revise a 1998 Oregon law under which state residents with chronic illnesses can obtain cards that allow them to use limited amounts of marijuana for medical purposes; the law requires patients, or their caregivers, to grow the marijuana plants. The measure would increase the amount of marijuana that registered patients can possess from three ounces to one pound and the number of marijuana plants from three to 10; allow nurse practitioners and naturopaths, rather than only physicians and osteopaths as current law allows, to sign patient applications for cards; allow designated caregivers to sell marijuana to as many as 10 registered patients, a practice prohibited under current law; and establish a network of marijuana dispensaries, regulated by the state Department of Human Services, to sell marijuana to registered patients or caregivers. According to supporters, such as patient advocacy groups, many patients with chronic illnesses cannot obtain access to marijuana under the current law (Colburn, Oregonian, 9/27). Some opponents, such as the White House Office of National Drug Control Policy ONDCP and law enforcement officials, maintain that the measure could lead to the complete legalization of marijuana (Crary, AP/Akron Beacon Journal, 10/14). Other opponents, such as the Oregon Medical Association, maintain that the measure makes unproven claims about the medical use of marijuana (Oregonian, 9/27).
- Measure 35: The measure would cap noneconomic damages in medical malpractice lawsuits at $500,000 and limit attorney contingency fees in such cases (Kaiser Daily Health Policy Report, 7/23). The measure would not apply to malpractice lawsuits that involve claims for wrongful death. Under the measure, the state could increase the cap based on the inflation rate. The measure would not cap economic damages (Kaiser Daily Health Policy Report, 10/8). Oregonians for Quality, Affordable and Reliable Health Care -- a group of physicians, hospitals and insurers -- and OMA support the measure. According to supporters, the measure would address the issue of increased malpractice insurance premiums, which they maintain have prompted many physicians to leave the state or end their practices. Trial attorneys and consumer and patient groups oppose the measure (Oregonian, 10/13). According to opponents, the measure would not allow adequate protection for patients who experience malpractice and would not lead to reduced malpractice insurance premiums (Kaiser Daily Health Policy Report, 10/1).
Wyoming
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Constitutional Amendment C: The measure, proposed by the Wyoming Legislature, would amend the state constitution to allow state lawmakers to pass legislation to require alternative dispute resolution or a review of medical malpractice claims by a committee before patients could proceed to court. The Wyoming Medical Society and other physician groups support the measure. Citizens for Real Insurance Reform -- a group supported by the Wyoming Trial Lawyers Association, the Equality State Policy Center, the Wyoming chapter of AFL-CIO and the Brain Injury Association of Wyoming -- opposes the measure (Associated Press, 10/26).
- Constitutional Amendment D: The measure, proposed by the Wyoming Legislature, would amend the state constitution to allow state lawmakers to cap noneconomic damages in medical malpractice lawsuits. The measure would not apply to economic damages (Kaiser Daily Health Policy Report, 9/27). According to supporters, such as WMS and other physician groups, the measure would help address the issue of increased malpractice insurance premiums, which they maintain have forced many physicians to leave the state. However, opponents, such as CRIR, maintain that the measure would not lead to reduced malpractice insurance premiums because Wyoming juries have not issued large damage awards in malpractice lawsuits (Kaiser Daily Health Policy Report, 10/8).