Amid intense scrutiny of 2020 Presidential election results, little attention has been paid to health-related state ballot initiatives. While COVID-19 limited citizens’ ability to collect signatures to get questions on the ballot, citizens and legislatures in nine states placed health care-related issues on their state ballots.
In Oklahoma, voters rejected a proposal to divert a portion of the state’s tobacco settlement dollars to help fund Oklahoma’s recent Medicaid expansion, which was recently enacted following a successful citizen referendum.
Marijuana initiatives: Three states – Mississippi, South Dakota, and Louisiana – joined the 33 states that have legalized medical marijuana, and Arizona joined the 11 states that allow recreational marijuana. Arizona’s marijuana sales revenues will support community colleges, municipal services, highways, and a new Justice Reinvestment Fund. Oregon has legalized psilocybin mushrooms and will use revenues to support drug treatment and community recovery centers.
Family leave: In Colorado, voters enacted a paid family leave law, funded by payroll taxes of employers and employees.
While 2020 had fewer state ballot questions, policymakers will note the re-emergence of taxes on tobacco and marijuana sales that may signal strategies for budget deliberations to come.