The NCSL Blog


By Emily Heller  

Dealing with issues ranging from biomedical research to prescription drug prices, voters in at least four states are gearing up to vote on health ballot initiatives and constitutional amendments this November.

Health Care System and Costs

Several states are considering ballot measures affecting the health care system or the cost of care.  

Colorado’s Constitutional Amendment 69, if passed, will create a state-based single payer health care program, called ColoradoCare. This system would pay for health care for all Colorado residents and be financed partly through an additional tax on employers and employees. Bills proposing to establish single payer systems have failed to pass in the last two legislative sessions in Colorado.

California Proposition 61, called the California Drug Price Relief Act, would prohibit state health agencies from paying more for a prescription drug than the lowest price paid for the same drug by the U.S. Department of Veterans’ Affairs.  

Also on the California ballot this November is Proposition 52 , which would extend indefinitely the law requiring fees on hospitals to be used as matching funds to obtain federal Medicaid money. The ballot initiative also directs these fees and matching federal funds to hospital-provided Medi-Cal (California’s Medicaid program) services, uncompensated care provided to uninsured hospital patients and children’s health coverage. The proposition would also increase the amount of votes needed to amend this law to two-thirds of the Legislature.

Nevada Question 4 would amend the state constitution to exempt durable medical equipment, oxygen delivery equipment and mobility enhancing equipment from sales and use taxes when prescribed by a health care provider. A similar proposal failed to pass the Nevada Legislature in 2015.

Additional Proposals

Voters in California, Colorado and Montana are considering additional health ballot measures this November. 

California Proposition 60, the Safer Sex in the Adult Film Industry Act, would require adult film performers to use condoms during filming of sexual intercourse. In addition, it would require adult film producers to pay for performer vaccinations, testing and medical examinations related to sexually transmitted infections.

Colorado Initiative 145, Access to Medical Aid-in–Dying Medication, would allow terminally ill adult patients to receive self-administered, life-ending drugs from a physician. If the initiative passes, Colorado would become the fifth state with a law allowing physicians to provide aid in dying.   

Montana Initiative 181 would establish the Montana Biomedical Research Authority to oversee and review grant applications for research and therapy development for brain diseases, brain injuries and mental illnesses. The grants would be funded by state general obligation bonds.     

For information on 2016 state ballot measures dealing with marijuana and tobacco, please click here . To learn more about the key issues facing voters this fall please visit NCSL’s Ballot Measures database.

Emily Heller is a research analyst in NCSL's Health program.

Email Emily

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This blog offers updates on the National Conference of State Legislatures' research and training, the latest on federalism and the state legislative institution, and posts about state legislators and legislative staff. The blog is edited by NCSL staff and written primarily by NCSL's experts on public policy and the state legislative institution.