Public health insurance ballot measures

Voters have decided on public health insurance ballot measures across the U.S. As a state ballot measure topic, public health insurance includes measures regarding [[Medicaid]], [[Medicare]], and single-payer public insurance systems. The topic is grouped within the labor, healthcare, and public assistance policy area.

This page provides information on:

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• Comprehensive list of ballot measures by year and state

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Labor, healthcare, and public assistance policy

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Public health insurance

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State ballot measures

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Upcoming ballot measures

See also: 2026 ballot measures and 2027 ballot measures

The following is a list of state ballot measures related to this topic that are certified or potential for this year and future elections:

2028

1. Florida Medicaid Expansion Initiative (2028) - Potential

2026

1. California One-Time Wealth Tax for State-Funded Health Care Programs Initiative (2026) - Potential
2. California Residency Criteria for State Taxes and Benefits Amendment (2026) - Potential
3. South Dakota Constitutional Amendment I, Medicaid Expansion Conditioned on 90% Federal Funding Amendment (2026) - On the ballot

List of state ballot measures

Click the tabs to view state ballot measures related to this topic, organized by year or state.

Years

States

2028

1. Florida Medicaid Expansion Initiative (2028) - Potential

2026

1. California One-Time Wealth Tax for State-Funded Health Care Programs Initiative (2026) - Potential
2. California Residency Criteria for State Taxes and Benefits Amendment (2026) - Potential
3. South Dakota Constitutional Amendment I, Medicaid Expansion Conditioned on 90% Federal Funding Amendment (2026) - On the ballot

2024

1. California Proposition 34, Require Certain Participants in Medi-Cal Rx Program to Spend 98% of Revenues on Patient Care Initiative (2024)
2. California Proposition 35, Managed Care Organization Tax Authorization Initiative (2024)
3. Illinois Assisted Reproductive Healthcare Advisory Question (2024)
4. South Dakota Constitutional Amendment F, Medicaid Work Requirement Amendment (2024)
5. Washington Initiative 2124, Opt-Out of Long-Term Services Insurance Program Initiative (2024)

2022

1. Oregon Measure 111, Right to Healthcare Amendment (2022)
2. South Dakota Constitutional Amendment D, Medicaid Expansion Initiative (2022)

2020

1. Missouri Amendment 2, Medicaid Expansion Initiative (August 2020)
2. Oklahoma State Question 802, Medicaid Expansion Initiative (June 2020)
3. Oklahoma State Question 814, Decrease Tobacco Settlement Endowment Trust Fund Deposits and Fund Medicaid Program Amendment (2020)

2018

1. Idaho Proposition 2, Medicaid Expansion Initiative (2018)
2. Montana I-185, Extend Medicaid Expansion and Increase Tobacco Taxes Initiative (2018)
3. Nebraska Initiative 427, Medicaid Expansion Initiative (2018)
4. Oregon Measure 101, Healthcare Insurance Premiums Tax for Medicaid Referendum (January 2018)
5. Utah Proposition 3, Medicaid Expansion Initiative (2018)

2017

1. Maine Question 2, Medicaid Expansion Initiative (2017)
2. Ohio Issue 2, Drug Price Standards Initiative (2017)

2016

1. California Proposition 52, Continued Hospital Fee Revenue Dedicated to Medi-Cal Unless Voters Approve Changes (2016)
2. California Proposition 61, Drug Price Standards (2016)
3. Colorado Creation of ColoradoCare System, Amendment 69 (2016)

2014

1. Illinois Birth Control in Prescription Drug Coverage Question (2014)

2012

1. Alabama Healthcare Amendment, Amendment 6 (2012)
2. Alabama Medicaid Amendment, Amendment 1 (September 2012)
3. Florida Amendment 1, Health Insurance and Payments Amendment (2012)
4. Louisiana Medicaid Trust Fund, Amendment 1 (2012)
5. Montana Healthcare Measure, LR-122 (2012)
6. South Dakota Sales Tax Increase Measure, Initiated Measure 15 (2012)
7. Wyoming Constitutional Amendment A, Right to Make Healthcare Decisions and Direct Healthcare Payments Amendment (2012)

2011

1. Ohio Issue 3, State Cannot Compel Healthcare Participation Amendment (2011)

2010

1. Arizona Proposition 106, Prohibit Mandatory Health Care System Participation Amendment (2010)
2. Colorado Amendment 63, Healthcare Choice and Coverage Initiative (2010)
3. Oklahoma State Question 756, Prohibit Mandatory Participation in Healthcare System Amendment (2010)

2008

1. Missouri Proposition B, Missouri Quality Home Care Council Initiative (2008)
2. Montana Initiative No. 155, Expand Child Health Insurance Coverage Measure (2008)

2006

1. Louisiana Medicaid Trust Fund for the Elderly Act, Amendment 7 (September 2006)
2. Missouri Amendment 3, Healthy Future Trust Fund Initiative (2006)
3. South Dakota Initiated Measure 2, Increase Taxes on Tobacco Measure (2006)

2005

1. Washington Initiative 336, Medical Malpractice Measure (2005)

2002

1. Montana Tobacco Disease Prevention, I-146 (2002)
2. Oregon Measure 20, Increased Cigarette Tax for State Health Plan Measure (September 2002)
3. Oregon Measure 23, Creation of Healthcare Finance Plan Initiative (2002)

2000

1. Arizona Proposition 204, Tobacco Litigation Settlement Fund Initiative (2000)
2. Massachusetts Question 5, Healthcare Council to Propose Comprehensive Coverage Legislation Initiative (2000)

1997

1. Washington Initiative 673, Health Insurance Regulation Measure (1997)

1996

1. Arizona Proposition 203, Lottery Revenues for Health Programs Initiative (1996)

1994

1. California Proposition 186, Single-Payer Healthcare System Initiative (1994)

1991

1. New Jersey Public Question No. 2 (1991)

1988

1. Georgia Amendment 14, Indigent Care Trust Fund Measure (1988)
2. Missouri Amendment 8, MedAssist Public Health Coverage and Earnings Tax Initiative (1988)

1987

1. Washington Initiative 92, Prohibit Physicians from Charging Medicare Patients Above Certain Rates Initiative Measure (1987)

1986

1. Massachusetts Question 7, National Healthcare Program Advisory Question (1986)

1958

1. Washington Referendum 30, Inheritance Tax on Insurance Measure (1958)

1918

1. California Proposition 20, Health Insurance Amendment (1918)

Alabama

1. Alabama Healthcare Amendment, Amendment 6 (2012)
2. Alabama Medicaid Amendment, Amendment 1 (September 2012)

Arizona

1. Arizona Proposition 106, Prohibit Mandatory Health Care System Participation Amendment (2010)
2. Arizona Proposition 203, Lottery Revenues for Health Programs Initiative (1996)
3. Arizona Proposition 204, Tobacco Litigation Settlement Fund Initiative (2000)

California

1. California One-Time Wealth Tax for State-Funded Health Care Programs Initiative (2026) - Potential
2. California Proposition 186, Single-Payer Healthcare System Initiative (1994)
3. California Proposition 20, Health Insurance Amendment (1918)
4. California Proposition 34, Require Certain Participants in Medi-Cal Rx Program to Spend 98% of Revenues on Patient Care Initiative (2024)
5. California Proposition 35, Managed Care Organization Tax Authorization Initiative (2024)
6. California Proposition 52, Continued Hospital Fee Revenue Dedicated to Medi-Cal Unless Voters Approve Changes (2016)
7. California Proposition 61, Drug Price Standards (2016)
8. California Residency Criteria for State Taxes and Benefits Amendment (2026) - Potential

Colorado

1. Colorado Amendment 63, Healthcare Choice and Coverage Initiative (2010)
2. Colorado Creation of ColoradoCare System, Amendment 69 (2016)

Florida

1. Florida Amendment 1, Health Insurance and Payments Amendment (2012)
2. Florida Medicaid Expansion Initiative (2028) - Potential

Georgia

1. Georgia Amendment 14, Indigent Care Trust Fund Measure (1988)

Idaho

1. Idaho Proposition 2, Medicaid Expansion Initiative (2018)

Illinois

1. Illinois Assisted Reproductive Healthcare Advisory Question (2024)
2. Illinois Birth Control in Prescription Drug Coverage Question (2014)

Louisiana

1. Louisiana Medicaid Trust Fund, Amendment 1 (2012)
2. Louisiana Medicaid Trust Fund for the Elderly Act, Amendment 7 (September 2006)

Maine

1. Maine Question 2, Medicaid Expansion Initiative (2017)

Massachusetts

1. Massachusetts Question 5, Healthcare Council to Propose Comprehensive Coverage Legislation Initiative (2000)
2. Massachusetts Question 7, National Healthcare Program Advisory Question (1986)

Missouri

1. Missouri Amendment 2, Medicaid Expansion Initiative (August 2020)
2. Missouri Amendment 3, Healthy Future Trust Fund Initiative (2006)
3. Missouri Amendment 8, MedAssist Public Health Coverage and Earnings Tax Initiative (1988)
4. Missouri Proposition B, Missouri Quality Home Care Council Initiative (2008)

Montana

1. Montana Healthcare Measure, LR-122 (2012)
2. Montana I-185, Extend Medicaid Expansion and Increase Tobacco Taxes Initiative (2018)
3. Montana Initiative No. 155, Expand Child Health Insurance Coverage Measure (2008)
4. Montana Tobacco Disease Prevention, I-146 (2002)

Nebraska

1. Nebraska Initiative 427, Medicaid Expansion Initiative (2018)

New Jersey

1. New Jersey Public Question No. 2 (1991)

Ohio

1. Ohio Issue 2, Drug Price Standards Initiative (2017)
2. Ohio Issue 3, State Cannot Compel Healthcare Participation Amendment (2011)

Oklahoma

1. Oklahoma State Question 756, Prohibit Mandatory Participation in Healthcare System Amendment (2010)
2. Oklahoma State Question 802, Medicaid Expansion Initiative (June 2020)
3. Oklahoma State Question 814, Decrease Tobacco Settlement Endowment Trust Fund Deposits and Fund Medicaid Program Amendment (2020)

Oregon

1. Oregon Measure 101, Healthcare Insurance Premiums Tax for Medicaid Referendum (January 2018)
2. Oregon Measure 111, Right to Healthcare Amendment (2022)
3. Oregon Measure 20, Increased Cigarette Tax for State Health Plan Measure (September 2002)
4. Oregon Measure 23, Creation of Healthcare Finance Plan Initiative (2002)

South Dakota

1. South Dakota Constitutional Amendment D, Medicaid Expansion Initiative (2022)
2. South Dakota Constitutional Amendment F, Medicaid Work Requirement Amendment (2024)
3. South Dakota Constitutional Amendment I, Medicaid Expansion Conditioned on 90% Federal Funding Amendment (2026) - On the ballot
4. South Dakota Initiated Measure 2, Increase Taxes on Tobacco Measure (2006)
5. South Dakota Sales Tax Increase Measure, Initiated Measure 15 (2012)

Utah

1. Utah Proposition 3, Medicaid Expansion Initiative (2018)

Washington

1. Washington Initiative 2124, Opt-Out of Long-Term Services Insurance Program Initiative (2024)
2. Washington Initiative 336, Medical Malpractice Measure (2005)
3. Washington Initiative 673, Health Insurance Regulation Measure (1997)
4. Washington Initiative 92, Prohibit Physicians from Charging Medicare Patients Above Certain Rates Initiative Measure (1987)
5. Washington Referendum 30, Inheritance Tax on Insurance Measure (1958)

Wyoming

1. Wyoming Constitutional Amendment A, Right to Make Healthcare Decisions and Direct Healthcare Payments Amendment (2012)

See also

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Footnotes

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