By Derek Monson
Published on November 7, 2018

Now that Election Day 2018 is in the rearview mirror, Utahns can think about the results of the ballot initiatives (Props 2, 3 and 4) and the nonbinding opinion question (Question 1) and determine the proper path forward for the policy issues involved – medical marijuana, Medicaid expansion, and gerrymandering.

Here’s a breakdown of the ballot initiatives after the 2018 midterms:

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Question 1: Gas Tax Increase for Education and Local Roads (10 Cents per Gallon)

Defeated on the ballot. The biggest takeaway is that when it comes down to it, Utah voters generally oppose higher taxes – including for public education – no matter what public opinion polls suggest. For more on Question 1 and improvements in education, see our recently published op-ed.

Proposition 2: Medical Marijuana Initiative

The success of this ballot initiative presents an interesting policy lesson: Legislative processes produce superior results to ballot initiatives. As can be seen by the legislative compromise negotiations on Prop 2, legislative processes drive consensus on policy matters, which generates the kind of buy-in from people that produces practical, sustainable policy solutions. The ballot initiative’s success and policymakers’ willingness to follow through on passing the compromise will inform answers to some interesting questions. For instance, do political stakeholders and elected officials in Utah put their integrity and long-term trustworthiness (i.e., their commitment to the legislative compromise) ahead of short-term leveraging of a political victory? We will know if and when the legislative compromise passes.

Proposition 3: Medicaid Expansion Initiative

Now that Utah will be expanding Medicaid (the ballot initiative passed), policymakers have an opportunity to reform the state’s Medicaid program in ways that will improve health care coverage for anyone in the program and protect everyone not in the program from Medicaid’s inadequacies.

Because Medicaid expansion will kick some Utahns off their coverage (those receiving Obamacare-subsidized coverage who now qualify for Medicaid), it is likely to fail in its promise to deliver good health care coverage to low-income Utahns – because Medicaid payments to doctors and hospitals are too low to overcome the problem of physicians being limited in how many Medicaid patients they see. And Medicaid expansion may go significantly over budget if trends seen in other states play out in Utah.

And since significant policy fixes to Prop 3 will be necessary, the Legislature has an opportunity to examine bigger problems with the state’s Medicaid program and pursue reforms to improve outcomes for all.

For example, the state could pursue a special waiver allowed under Obamacare – on which the Trump administration has announced it wants to grant states flexibility – combined with traditional Medicaid waivers that could exempt Utah from many of Medicaid’s flaws. Perhaps Utah could put as many Medicaid enrollees as possible into the commercial health insurance we all seek out for ourselves.

This would have the added benefit of focusing Medicaid coverage on the most vulnerable populations, for whom traditional health insurance is inadequate. Instead of crafting a standardized Medicaid approach that doesn’t fit anyone especially well, the state can customize Medicaid funding and coverage for Utah’s most vulnerable populations.

Proposition 4: Independent Redistricting Commission Initiative

As with Proposition 3, the inadequacies of Prop 4 (which looks like it will pass, but at the time of this writing, is still not determined) will require policymakers to step in. Prop 4 will generate lawsuits that put legislative, congressional and state school board maps into the hands of judges who are unaccountable to voters.

This was not done intentionally, perhaps, but it is certainly how its policy mechanisms – such as giving any person or party the right to sue if they think maps do not meet loosely defined legal standards – will operate. Because it is the constitutional duty of legislators (under the state constitution) to decide voting maps in Utah, they are likely to fulfill the oath they have taken to defend the constitution by significantly reforming the policies enacted by Prop 4.

The intent of the voters will be respected – the advisory commission supported by voters and some commonsense guidelines for maps drawn by the commission seem likely to be kept. But the more obscure and damaging details of Prop 4 – which go deeper than “gerrymandering is bad” and “legislators shouldn’t choose their voters” rhetoric of the ballot initiative campaign – will be changed out of the necessity of maintaining Utah’s constitutional system and protecting a healthy democratic republic. Elected officials who can be held accountable to voters, rather than judges who lack such accountability, should be making the decisions that affect the people the most.

As we look at Election Day 2018 in hindsight, we recognize that there remains much work to be done when it comes to Utah’s ballot initiatives. Further, there is a lot that lawmakers can (and should) do to ensure Utah laws and public policies reflect sound principles and Utah values. While some important political and policy decisions were made by voters this year, Election Day 2018 represents not so much the end of a political and policy dialogue, but the beginning of a new one.

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