The 2020 Election: Statewide Ballot Measures

Today is the day. It’s finally election day. We’ve spent a lot of time talking on the blog about what is on the ballot during this election as it relates to healthcare, from responding to the COVID-19 public health emergency to the future of the healthcare system and what it means for the tens of millions of Americans whose access to affordable health insurance will depend on the outcome of this election. If that wasn’t a reason enough to get out and vote today, it’s also important to know that voters across the country will also be voting on statewide ballot measures on a variety of policy areas. For our last 2020 election post, we wanted to highlight what other healthcare implications this election will have, on issues such as abortion, marijuana legalization, and access to treatment for substance use disorder. This list was compiled by the National Conference of State Legislature’s database. For the full list, please click here


Colorado: Prohibition of Late-Term Abortions (Proposition 115) 

Prohibits abortions after a fetus reaches 22 weeks gestational age. 

Louisiana: No Right to Abortion (Amendment 1) 

Adds a section to the Constitution of Louisiana that states nothing in the constitution shall be construed to secure or protect a right to abortion or require the public or private funding of abortion. 

Civil and Constitutional Law 

Montana: Concealed Carry Laws (LR-130)

Revises firearms laws to secure the right to keep and bear arms and to prevent a patchwork of restrictions by local governments across the state and providing that local governments may not regulate the carrying of concealed weapons.

Criminal Justice

California: Voting Rights Restoration for Persons on Parole Amendment 

Restores the right to vote to people convicted of felonies who are on parole.

Drug, Alcohol, Tobacco Policy 

Arizona: Marijuana Legalization Initiative (Proposition 207) 

Legalizes the recreational possession and use of marijuana.

Colorado: Cigarette Tobacco and Nicotine Products Tax (Proposition EE) 

Increases tax on tobacco, creates a new tax on nicotine products such as e-cigarettes; dedicates funds to education and health programs.

District of Columbia: Entheogenic Plants and Fungus Measure (Initiative 81)

Declares that investigations and arrests related to non-commercial prices with entheogenic plants and fungi are among the district’s lowest law enforcement priorities.

Mississippi: Medical Marijuana Amendment (Initiative 65 and Alternative 65a) 

Legalizes medical marijuana for qualified persons with debilitating medical conditions. Voters can signify whether they want either Initiative 65 or Alternative 65A to pass, thereby allowing the use of medical marijuana by qualified patients. The voter must then proceed to the second question to choose their preferred version. Voters can also signify neither measure (against both), and can then proceed to the second question to choose their preferred version in the event the “either” option gets more votes. 

Measure text: Initiative 65: Initiative Measure No. 65 proposes to amend the Mississippi Constitution to allow qualified patients with debilitating medical conditions, as certified by Mississippi licensed physicians, to use medical marijuana. This amendment would allow medical marijuana to be provided only by licensed treatment centers. The Mississippi State Department of Health would regulate and enforce the provisions of this amendment. 

Alternative 65A: This constitutional amendment is proposed as a legislative alternative measure to Initiative Measure No. 65 and would establish a program to allow the medical use of marijuana products by qualified persons with debilitating medical conditions.

Montana: Allow for a Legal Age for Marijuana Amendment (Ballot Issues #11)

Authorizes the legislature or a citizen initiative to set a legal age for marijuana purchase, use, and possession.

Montana: Marijuana Legalization and Tax Initiative (Ballot Issue #14)

Legalizes marijuana for individuals over the age of 21 and taxes the sale of non-medical marijuana at a rate of 20 percent.

New Jersey: Marijuana Legalization (Public Question 1) 

Adds an amendment to the state constitution that legalizes the recreational use of marijuana, also known as cannabis, for persons over a certain age and legalizes the cultivation, processing, and sale of retail marijuana.

Oklahoma: Decrease Tobacco Settlement Endowment Trust Fund Deposits and Fund Medicaid Program Amendment (Question 814)

Decreases payments made to the Tobacco Settlement Endowment Trust Fund from 75% to 25%, directs the legislature to appropriate money from the fund to secure federal matching funds for the state’s Medicaid program.

Oregon: Drug Addiction Treatment Initiative (Measure 110)

Decriminalizes possession of certain drugs and establishes a drug addiction treatment and recovery program funded by the state’s marijuana tax revenue.

Oregon: Psilocybin Program Initiative (Measure 109)

Legalizes psilocybin mushrooms for Oregon Psilocybin Services Program under the Oregon Health Authority.

South Dakota: Marijuana Legalization Initiative (Constitutional Amendment A) 

Legalizes the recreational use of marijuana for individuals over a certain age; authorizes individuals to possess or distribute up to one ounce of marijuana; requires the State Legislature to pass laws providing for a program for medical marijuana and the sale of hemp by a specified date.

South Dakota: Medical Marijuana Initiative (Initiated Measure 26)

Establishes a medical marijuana program in the state for individuals who have a debilitating medical condition as certified by a physician; provides that patients would be allowed to possess a maximum of three ounces of marijuana; limits the amount of cannabis products a person may possess as set by the Department of Health; allows registered to cultivate marijuana and grow three plants or another amount with a physician’s prescription.


Washington: Sex Education in Public Schools Measure (Referendum 90) 

Repeals Senate Bill 5395 (2020), which requires public schools to provide comprehensive sexual health education for all students and requires students to be excused if requested by their parents.


Arkansas: Practice of Optometry Referendum (Issue 6)

Note: Although this question will appear on the ballot, the results will be neither counted nor certified. A referendum on Act 579 (House Bill 1251), which amends the definition of practice of optometry to allow optometrists to perform surgical procedures.

California: Regulation of Kidney Dialysis (Proposition 23)

Authorizes state regulation of kidney dialysis clinics. Establishes minimum staffing and other requirements.

California: Stem Cell Research Institute Bond Initiative (Proposition 14)

Issues $5.5 billion in bonds for state stem cell research institute 

Colorado: Paid Family and Medical Leave Insurance Program (Proposition 118) 

Establishes a program for paid medical and family leave 

Oregon: Cigarette Tax Increase (Measure 108) 

Creates an additional tax upon distributions of cigarettes at the rate of 100 mills for each cigarette in the state. Provides that all money received from the cigarette tax be paid to the State Treasurer. It shall first be used to pay administrative and enforcement expenses and refunds, and the remaining balance shall be sued by the Oregon Health Authority Fund

What’s at Stake

We’ve all heard it before: this election is the most consequential in generations. There is so much at stake today, and like many of you, we here at The Grassroots Pharmacist are a anxious about the outcomes of today’s election. We’ve spent the greater part of the last six months trying to inform our readers about the health implications of various federal and state policies, and trying to provide you with the best tools to advocate for your patients, yourselves, and the pharmacy profession at large. Of all the tools that we’ve provided for you though, nothing is more important than voting. Your vote is the single greatest way that you can advocate and regardless of your views, you have a responsibility to shape the future and direction of this country. Grassroots advocacy starts with each one of you, and with your vote you plant the seeds for what the future will look like. To all of our readers, we ask that if you haven’t voted, please vote today. There’s too much on the line to sit this out.

Published by The Grassroots Pharmacist

We are pharmacists passionate about engaging pharmacists in advancing health policy

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