Massachusetts voters to consider 3 ballot questions

Nov. 04--On Nov. 6, Massachusetts voters will be asked to vote on three ballot questions. The state is only one of a handful on the East Coast where citizens can make or change state laws in the voting booth.

Here's a fact sheet for voters outlining the arguments for and against each question.

Question 1: Nurse staffing ratios

If this referendum passes, it would enact legal limits on the number of patients assigned to each nurse in Massachusetts hospitals, varying for the hospital unit and patient conditions.

A yes vote would put nurse-patient ratios in to effect. The Massachusetts Nurses Association, a union representing about 20 percent of nurses statewide, is the main group pushing for this initiative. Advocates of legal staffing limits say the current staffing levels are unsafe, that this law could attract more people to the profession due to lower caseloads, and that an increased number of nurses would improve quality of care.

A no vote would keep the current system in place, which allows hospitals to determine nurses' assignments. The Massachusetts Health and Hospital Association is leading the opposition. Opponents of nurse ratios say it would not lead to better care, and may force hospitals to pull nurses from places like nursing homes to meet staffing requirements. They claim it would be a massive financial burden, and could force hospitals to close units that don't make money, but serve the most vulnerable.

The Health Policy Commission, an independent agency, estimated the cost to implement Question 1 at $676 million to $949 million. The commission also reported that community hospitals with a high percentage of Medicaid/Medicare patients would have to hire the most new nurses.

Question 2: Commission to examine limiting money in politics

If this referendum passes, it would create a commission of unpaid citizens to write a report examining money in politics. This report would then propose language for a new amendment to the U.S. Constitution that would let Congress regulate political contributions and ensure that only individuals -- not corporations or unions -- could spend money on campaigns.

A yes vote would establish the commission on limiting money in politics. The main group pushing for this ballot question is American Promise, established to pass a campaign finance amendment nationally. Advocates say this initiative is a way for Massachusetts voters to go on record opposing the Supreme Court's 2010 Citizens United decision, which ultimately allowed unlimited political contributions by corporations. The court ruling made it so corporations, unions, and individuals can all contribute through Political Action Committees, or PACs. Advocates of overturning it say the decision actually stifles the average person's voice, because they do not have the kind of money to compete with massive companies.

A no vote would change nothing. No commission would be established. A conservative fiscal watchdog group, the Massachusetts Fiscal Alliance, has spoken out against Question 2, saying it is a waste of resources. Opponents to the commission say Citizens United clarified rules around campaign finance: Everyone, including corporations, unions and individuals, have an equal voice because of the ruling. Mass Fiscal's opposition statement frames Question 2 as an issue of free speech: "Even if you disagree with the Citizens United decision, an amendment to the United States Constitution is a dangerous and misguided way to go about undoing it."

Nineteen states, including Massachusetts, have called on Congress to overturn Citizens United.

Question 3: Transgender protections

This referendum asks voters whether to keep a 2016 state law that prohibits discrimination against transgender people in public spaces like restaurants, hospitals, gym locker rooms, and hotels.

Under the existing law, if there are separate public spaces for males and females, like bathrooms, transgender people can use the space that matches their gender identity, rather than their biology or sex at birth.

A yes vote would keep the 2016 law on the books. The organization leading the campaign to do so is a transgender advocacy group called Freedom For All Massachusetts. Advocates of the 2016 law say it makes for a safer environment for transgender people who can face harassment, and that there has been no increase in attacks against women in places like restrooms since it has gone into effect.

A no vote would repeal the 2016 law. The Massachusetts Family Institute, a socially conservative advocacy group, spearheaded the referendum to repeal this law. Opponents of the 2016 law claim that any man -- or convicted sex offenders -- can exploit the law and access locker rooms and restrooms, and threaten women's safety.

This is the first statewide referendum on transgender rights in the country. Since Donald Trump was elected, his administration has reversed an Obama-era interpretation of the Civil Rights Act of 1964 that protected transgender people, making it so there are currently no express prohibitions on discrimination against transgender people.

Massachusetts Law already prohibits discrimination against transgender people in housing, employment, and public education. These laws remain unchallenged.

For more information about the ballot questions, visit the Secretary of State Bill Galvin's website.

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