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November 9, 2022

2022 midterms: These health care initiatives passed on state ballots

Daily Briefing

    With many states still counting votes, control of Congress remains undecided. But many health care-related ballot measures have passed throughout the United States, including proposals related to abortion rights, medical debt, Medicaid expansion, and more.

    The results of the 2022 midterms (so far)

    Abortion rights

    California, Michigan, and Vermont all voted Tuesday to codify the right to abortion into their state constitutions.

    In Michigan, voters approved an amendment that would bar the state from enforcing its 1931 abortion ban. Meanwhile, in California, voters approved a constitutional amendment saying a person has a "fundamental right to choose to have an abortion," and in Vermont, voters approved an amendment stating that "an individual's right to personal reproductive autonomy is central to the liberty and dignity to determine one's own life course and shall not be denied or infringed unless justified by a compelling State interest achieved by the least restrictive means."

    Meanwhile, voters in Kentucky rejected a proposed amendment that would have stated, "to protect human life, nothing in this Constitution shall be construed to secure or protect a right to abortion or require the funding of abortion."

    According to Elisabeth Smith, director for state policy and advocacy at the Center for Reproductive Rights, the rejection of the Kentucky amendment sends a "powerful and positive statement" that the public believes "this health care service should remain legal and accessible."

    And in Montana, voters are voting on a state law saying infants "born alive" at any stage of pregnancy are granted "legal person" status. Any health care provider found guilty of "failing to take medically appropriate and reasonable actions to preserve a born-alive infant's life" would face a fine of up to $50,000 and/or a prison sentence of up to 20 years.

    As of this morning, the ballot measure in Montana was too close to call, with 52.6% voting no and 47.4% voting yes with 80% of votes in.

    Medical debt

    In Arizona, voters approved Proposition 209, which will reduce the maximum amount of interest creditors are allowed to charge on medical debt from 10% to 3%.

    The proposition will also increase the number of assets that are exempt from debt collection and will allow courts to reduce how much of a person's earnings can be garnished to pay medical debt.

    Medicaid expansion

    In South Dakota, voters on Tuesday approved a ballot measure expanding Medicaid to people ages 18 to 65 with incomes below 133% of the federal poverty line. The move will extend Medicaid benefits to more than 40,000 low-income adults.

    "South Dakotans know their families and neighbors deserve health care without going into debt or avoiding check-ups, procedures, and medication they need," said Kelly Hall, executive director of the Fairness Project. "Citizens took matters into their own hands to pass Medicaid expansion via ballot measure—showing us once again that if politicians won't do their job, their constituents will step up and do it for them."

    Now, just 11 states have yet to expand Medicaid under the Affordable Care Act.

    Health care as a human right

    In Oregon, voters are voting on a ballot measure that would declare health care as a human right. According to the measure, "It is the obligation of the state to ensure that every resident of Oregon has access to cost-effective, clinically appropriate, and affordable health care as a fundamental right."

    As of this morning, the vote was too close to call.

    If the measure passes, it would make Oregon the first state in the country establishing a constitutional right to health care. However, according to Oregon Public Broadcasting, the ballot measure doesn't say what the state would have to do to meet the constitutional obligation to provide health care, nor does it define what access to affordable health care means. If passed, the state legislature would have to determine what health care access for everyone looks like and how it's paid for, Oregon Public Broadcasting reports.

    Joseph Antos, a senior fellow at the American Enterprise Institute, said he believes Oregon's ballot measure is "virtue signaling."

    "Mostly what I see is trouble here, if they pass this," he said, adding that, since Oregon is a very rural state, someone could have to travel hours to reach a hospital that can address their health problem, which could be argued as a violation of a human right.

    Flavored tobacco

    In California, voters on Tuesday approved a ballot measure upholding a 2020 law banning the sale of candy and fruit-flavored tobacco products.

    "In California's battle against Big Tobacco, voters have overwhelmingly decided to protect kids from being lured into a lifetime of addiction to nicotine," said Lindsey Freitas, regional advocacy director for the Campaign for Tobacco-Free Kids.

    Recreational marijuana

    Two states—Missouri and Maryland—passed ballot measures legalizing marijuana for recreational use on Tuesday.

    In Missouri, voters approved a measure that will remove bans on purchasing, owning, and selling recreational marijuana for all adults over the age of 21. The measure will also allow people convicted of non-violent marijuana offenses to petition for release from incarceration or parole and have their records expunged.

    Meanwhile, in Maryland, voters approved a ballot measure allowing adults 21 and older to possess up to 1.5 ounces of marijuana and grow two plants out of public view starting on July 1, 2023.

    Dialysis clinic staffing

    In California, voters rejected a measure that would have established a statewide mandate to increase medical staffing at dialysis centers.

    The proposition would have required that dialysis clinics have a doctor, nurse practitioner, or physician assistant present while patients receive care. The clinics would also have been required to disclose whether a physician had ownership interest in a facility and report patient infection data. (Gonzalez, Axios, 11/9; Reed, Axios, 11/8; Owermohle, STAT, 11/9; Firth/Frieden, MedPage Today, 11/7; Choi, The Hill, 11/9; Wiley, Los Angeles Times, 11/8; Jaspen, Forbes, 11/9; Evans, Los Angeles Times, 11/8; Templeton, OPB, 11/9; Elwood, Washington Post, 11/8)

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