Here is a brief rundown of what's at stake tomorrow in terms of particular interest to pharmacists, student pharmacists and pharmacy technicians.
Obamacare, Medicaid and the Federal Medicaid Program
Reelecting Obama and Biden will mean implementation of the Patient Protection and Affordable Care Act will continue on schedule. In stark contrast, Romney and Ryan have campaigned on promises to get most provisions of the law commonly known as Obamacare repealed. Under a Romney administration, the Medicare Part D prescription drug coverage gap, or donut hole, may no longer close by 2014. Also, planned expansions of Medicaid through Obamacare, already put on hold, have almost no chance of occurring with Republicans in the White House.
With Romney as president, expect pushes to to convert the current system of federal-state cost-sharing for Medicaid to a block grant program. A key provision of a widely endorsed budget plan introduced in the U.S. House of Representatives by Paul Ryan calls for sending states fixed amounts of Medicaid funds each year and allowing nearly all decisions on how to spend those dollars to state administrators.
Medicare may also become a voucher program, meaning beneficiaries would no longer have covered health care services paid for as they are delivered. Rather, seniors and disabled adults would be allocated a certain amount of money to purchase a Medicare insurance plan on an open market. It is currently unclear whether Medicare vouchers would buy the same amount of coverage as current benefits formulas.
State Medicaid Ballot Initiatives
Perhaps anticipating shrinking contributions from the federal government, two states placed referendums for state constitutional amendments to protect Medicaid trust funds. Such a proposal was approved by Alabama voters this September. The ballot in Louisiana features a similar question.
Legalizing Marijuana for Medical and Recreational Use
Also appearing on several states' ballots will be questions regarding the legalization of marijuana for medical and recreational use. The website ProCon.org presents summaries for medical cannabis proposals in Arkansas, Massachusetts and Montana. Illinois, New York, Ohio and Pennsylvania also have pending bills, but voters will not be getting a chance to pass or defeat those directly. Seventeen states and the District of Columbia already permit health care providers to prescribe and dispense marijuana to patients.
Federal authorities, however, continue to classify marijuana as a Class I controlled substance with no recognized health benefits. Companies and individuals involved in growing, processing, selling and using cannabis face possible federal prosecution regardless of what local laws allow.
Three states are set to fully test the willingness of Drug Enforcement Administration, FBI and U.S. Treasury agents to continue enforcing such restrictions, though. Colorado, Oregon and Washington ballots contain referendums on regulating marijuana like alcohol.
Have a Flu Vaccination and a Ballot
Now for some nonpolitical voting news.
Hundreds of polling places in more than 40 states have been designated Vote & Vax sites. Pharmacists, nurses and other state-licensed health care providers will be on hand at schools, precincts, firehouses and churches to administer flu shots to people who have not had a chance to get this year's vaccination.
Registration for vaccinators has concluded for this year, but keep an eye out for your chance to volunteer during upcoming elections.
Obama photo by Pete Souza, used courtesy of the White House
Romney photo courtesy of Mark Taylor