Polled voters ranked healthcare policies among the top issues affecting their federal election decision, with 65% considering them “very important.” Healthcare measures are also on many state ballots, and several other measures significantly impact medical policy. 

Lower turnout in non-presidential elections indicates many people prioritize presidential votes above others. They might be unfamiliar with state issues. Armed with an online research tool kit and the following summary of a few trickier ones, voters can make wise choices about state laws governing their medical care. 

Colorado Proposition KK

Although it appears to be just a gun tax, Proposition KK has a crucial hidden tie to health care. It proposes a 6.5% excise tax on the sale of firearms and ammunition. Revenue from this tax, predicted to be $35 million annually, would be distributed to crime victim services and mental health programs.

Pros and cons: Gun and ammo manufacturers, sellers, and owners (who will absorb some of the increased cost from sellers) will be penalized for crimes they did not commit and mental health issues they neither cause nor suffer from. This so-called excise tax is really a sin taxon an object protected by the Second Amendment. Guns are being treated as a sin.

If passed, it will be difficult to overturn, because once the victim and health services expect the yearly $35 million, they will rely on it. Any attempt to remove that funding will elicit claims they have no way to pay for care. Gun supporters will, once again, be the “bad guys.”

No pros here, just overt manipulation of Colorado residents.

California Proposition 35

Passing Proposition 35 would make the current tax affecting managed healthcare insurance providers permanent. (It will otherwise expire in 2026). California faces a budget deficit, and proponents insist this tax will use insurance company money to fill the coffers—without raising prices for insured individuals.

Pros and cons: California spent itself into a deficit, and it demands more taxes instead of better 

efficiency to solve the ongoing problem. Just as the Proposition KK supporters do, Proposition 35 supporters ignore basic economic theory to claim the insured are not harmed by higher taxes on their insurers. They are harmed.

This bill also locks legislators into a commitment to use the taxes for specific intended causes, which could be seen as a pro. However, a better alternative would be to stop handing legislators money with no specified intention. 

Drug Legalization 

Laws regulating drugs straddle the line between criminal justice and health care, but all are inextricably linked to the healthcare system. Individuals often use substances in an effort to manage physical or mental ailments. And if addiction or overdose results, these individuals access health care. Anyone interested in health policy therefore needs to examine laws governing drugs.

Five states have measures legalizing either marijuana or psychedelics on the ballot. Florida, North Dakota, and South Dakota have measures addressing recreational marijuana, Nebraska has two measures addressing medical marijuana, and Massachusetts has a measure addressing psychedelics. Details of the bills naturally vary, and voters in these states should examine their particular bills. But, all stipulate a legal possession amount and minimum age, as well as some government oversight over production and distribution. And all should be considered in the greater context and history of prohibition. 

Pros and cons: Legalization lowers the incentive to utilize nefarious underground sources, rendering accidental consumption of tainted products less likely. This has always been a concern, but it merits particular attention since the fentanyl explosion. Fentanyl is 100 times stronger than morphine, requiring only a tiny hidden amount to cause unintentional overdose. It resulted in 73,838 overdose deaths in 2022, and many of these users were likely unaware they were ingesting it. 

The risk to someone breaking a current law is obviously not itself a reason to reverse it, if the prohibited behavior directly harms innocent people. But criminalizing mere consumption of any substance brings up ethical considerations. These laws are designed to prevent possible future behavior resulting from substance use, so they essentially punish behavior that may never occur. 

Added to these areas of concern is enforcement. Costs incurred by law officers, courts, and incarceration penalize innocent taxpayers. Lost wages and productivity of offenders harm their families and future employability. When considered alongside previously noted factors, it seems wise to at least relax current laws. 

Is Health Care On Your State Ballot?
Yes. “Health care” might not even appear in the name, and the text may not emphasize it. But your state ballot has something on it that affects your health care. Just take a look, and you’ll be ready to make an informed decision.