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The debate over Medicaid explained

Medicaid is often at the center of the health care debate. CNN's Dr. Sanjay Gupta explains why it matters.

Posted: Nov 6, 2018 8:30 PM
Updated: Nov 6, 2018 8:56 PM

Midterm voters in 37 states are deciding on more than 150 statewide ballot measures reflecting the biggest social and political issues of the moment.

Some were initiated by citizens, others by lawmakers. Questions include whether to restrict abortion funding, expand Medicaid access, or end greyhound racing in Florida.

Voters in at least four states -- Kentucky, Georgia, North Carolina and Oklahoma -- approved measures that create constitutional rights for victims of crime. And Florida voters chose to end a lifetime ban on voting for people convicted of certain felonies.

We'll be updating this story with results throughout the night.

Crime, justice and sentencing

Voters in six states -- Florida, Georgia, Kentucky, Nevada, North Carolina and Oklahoma -- considered some version of a measure often called "Marsy's Law." South Dakota passed one in June.

The proposals varied from state to state, but each would add specific protections for victims of crime to a state's constitution. Such protections include the right to be notified about hearings or the release of the accused, the right to restitution or the right to refuse an interview or deposition at the request of the accused.

Supporters of Marsy's Law say it gives victims more say in what happens in their cases. Opponents, including the American Civil Liberties Union, said victims already have these types of rights through state laws and warned that enshrining victims' rights in state constitutions creates a false equivalency between them and the rights of the accused. They warn that Marsy's Law could undermine the rights of the accused and divert resources from those in need.

Washington state's initiative 940 would change the legal standard for use of deadly force in officer-involved shootings. It would effectively lower the bar for prosecuting officers by establishing a good faith standard for opening fire.

The measure would also require law enforcement officers to receive ongoing training in violence de-escalation and how to interact with people with mental health issues. And it would establish a duty for officers to render first aid.

Ohio Issue 1 would make it a misdemeanor instead of a felony to use or possess illegal drugs such as fentanyl, heroin, methamphetamine, cocaine or LSD. And it would prohibit jail time as a sentence until an individual's third offense within 24 months.

For "noncriminal" probation violations, it calls for "a graduated series of responses, such as community service, drug treatment, or jail time."

Election policies

Ohio voters in May approved a statewide measure to establish a new redistricting system. Four more states -- Colorado, Michigan, Missouri and Utah -- decided similar measures for their state legislatures, their congressional districts, or both.

Nine states considered measures related to voting requirements and ballot access.

Maryland and Michigan voters considered whether to allow voter registration on election day. Ballots in Michigan and Nevada asked whether to allow automatic voter registration for those who interact with certain government agencies.

Voters in Arkansas and North Carolina will choose whether to require voters to present a photo ID to vote in person.

North Dakota's Measure 2 would amend the state constitution to say that "only a citizen" of the United States can vote, instead of what it currently says: "every citizen."

Florida voters passed Amendment 4, which proposed restoring voting rights for felons after they complete their sentences, including parole or probation, except for those convicted of murder or a felony sexual offense.

Montana's Ballot Collection Measure would ban people from collecting the election ballots of other people, with exceptions for certain individuals.

Louisiana Amendment 1 would prevent felons from seeking office or holding a public office until five years after the completion of their sentences.

Measures related to campaign finance, political spending and ethics were on the ballots in Colorado, Massachusetts, North Dakota and South Dakota.

Marijuana

Six measures on four state ballots concerned the legalization of recreational or medical marijuana.

Missouri had three competing measures. All of them proposed to legalize marijuana for medical purposes, but with different proposed sales tax amounts and revenue uses:

- 2% tax, with revenue to be spent on veterans' services, drug treatment, education and law enforcement

- 15% tax, with revenue to be spent on a biomedical research institute

- 4% tax, with revenue to be spent on health care services for veterans

Voters in Utah are deciding whether to legalize medical marijuana, and Michigan and North Dakota voters weighed citizen initiatives to legalize recreational marijuana.

Oklahoma voted in June to approve medical marijuana.

Abortion

Three measures in three states concerned abortion access and funding.

In Alabama and West Virginia, voters considered whether to amend their state constitutions to say that they do not protect the right to an abortion or require funding of abortions.

A "yes" vote for Alabama's Amendment 2 would also change the state constitution to say that it supports the rights of unborn children, giving them constitutional protections.

Oregon's Measure 106 would prohibit publicly funded health care programs from covering abortion. Like West Virginia's Amendment 1, the Oregon measure would prevent state taxpayer money from being used to pay for abortions for those on Medicaid.

Oregon's measure provides exceptions for when the mother suffers from a physical disorder, injury or illness that could endanger her life unless an abortion is performed, and for ectopic pregnancies.

Minimum wage

Two measures in two states proposed increasing the minimum wage to $11 by the year 2021 in Arkansas, and to $12 by 2023 in Missouri.

Medicaid expansion and health care

Four measures on four state ballots in November concerned Medicaid expansion or funding for Medicaid expansion.

Voters in Idaho, Utah and Nebraska considered whether to require their state governments to accept the Obamacare Medicaid expansion. In Montana, voters had the chance to force the state to continue accepting the expansion.

The initiatives in Montana and Utah proposed a tobacco tax increase and a sales tax increase, respectively, to provide funding for the expanded coverage. In January, Oregon voters approved a measure upholding legislation to provide funding for expanded Medicaid coverage through a tax on health insurers and revenue of certain hospitals.

Other health care-related measures included two propositions in California: one authorizing $1.5 billion in bonds to upgrade children's hospitals in the state and another affecting operations in dialysis clinics.

A "yes" vote for Massachusetts Question 1 supports an initiative to establish patient assignment limits for registered nurses in hospitals.

In Nevada, Question 2 would amend the Sales and Use Tax Act of 1955 to remove taxes on feminine hygiene products, also known as the pink tax.

More to watch

Florida's Amendment 13 creates a prohibition on racing or betting on greyhounds or other dogs by 2020. Nearly 70% of voters

Massachusetts Question 3 asked voters if they want to keep a state law prohibiting discrimination against transgender people in public places.

A "yes" vote for Alabama's Amendment 1 would add language to the state constitution authorizing the display of the Ten Commandments on state and public property, including schools, and prohibit spending public funds to defend the constitutionality of the amendment.

California's Proposition 6 would repeal fuel and vehicle taxes passed by the legislature in 2017 for road repairs and public transportation.

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