health policy

Faculty Explain Key State Ballot Measures in Voters’ Hands This Election

Paul Shafer, Noel Vest, Carlos Rodriguez-Diaz, and Kimberly Nelson guide us through some of the policy issues that will appear on multiple state ballots in the 2024 election, from wage changes for tipped workers to same-sex marriage language in state constitutions.

Proposed laws that affect public health are on the ballot in many states, with voters deciding potential changes to abortion laws, drug use policies, same-sex marriage, and wages for service industry workers.

On November 5, voters across the country will decide 11 abortion-related ballot measures—the most on record for a single year, according to Ballotpedia. Ten of the proposed changes to state laws would enshrine constitutional rights to abortion in Arizona, Colorado, Florida, Maryland, Missouri, Montana, Nebraska, New York, Nevada, and South Dakota. One ballot initiative in Nebraska would restrict the timeframe when an abortion can be performed.

Voters in California, Colorado, and Hawaii will vote on constitutional amendments to repeal outright bans or restrictions on same-sex marriage. The landmark Supreme Court decision in Obergefell v. Hodges superseded previous state-level bans but most of those outdated laws remain in state constitutions.

In Massachusetts, ballot Question 4 asks voters to weigh in on a proposed law that would allow persons aged 21 and older to grow, possess, and use five natural psychedelic substances under certain circumstances. The psychedelics in question are two found in mushrooms (psilocybin and psilocyn) and three found in plants (dimethyltryptamine, mescaline, and ibogaine). These substances could be purchased at an approved taxable location for use under the supervision of a licensed facilitator, or to be grown for home use. If passed, the measure would make Massachusetts the third state, after Colorado and Oregon, to allow limited personal and therapeutic use of psychedelics.

MA Question 4 is one of several across the country involving drug use policies, with voters in three states—Florida, North Dakota, and South Dakota—deciding marijuana legalization ballot measures. In California, Proposition 36 would increase penalties for people convicted of certain drug or theft crimes, including higher fines and longer prison sentences. It would also enable more drug users to obtain treatment by classifying certain drug offenses as treatment-mandated felonies, possibly reducing the overall number of people sent to prison for non-violent drug offenses.

Question 5 in Massachusetts will decide whether to raise the state’s minimum wages for tipped workers. On the surface, this ballot measure may not appear to have an immediate connection to health, however the potential increase in wages for lower-income workers could likely affect some of the social determinants that affect health.

This proposed law would gradually increase over the course of five years the minimum hourly wage an employer must pay a tipped worker to meet 100 percent of the state minimum wage on January 1, 2029. Employers would be permitted to administer “tip pools” that combine all tips given by customers to tipped workers and distribute them among all non-management workers, including non-tipped workers.

For more information on ballot measures across the country, including specific language of the proposed changes, please visit Ballotpedia.