Issue 2: What You Need to Know About the Rx Ballot Issue

If you have been anywhere near a television or social media recently, you likely have heard of Issue 2.  The statewide ballot issue proposes to regulate how state government purchases prescription drugs.  Ohio voters will decide Issue 2 on Election Day this November.

The Ohio Chapter, American Academy of Pediatrics studied the proposal and while supports the concept, finds the actual amendment problematic in implementation and is therefore listed in opposition.  The Ohio AAP is concerned about the lack of operational detail and many flaws within the proposal.

If passed, Issue 2 would require state government to pay no more than the lowest price paid by the U.S. Department of Veterans Affairs (VA), for prescription medications needed for state-run programs, including Medicaid beneficiaries, state workers, public retirees, prisoners, and people in other state health care programs.

However, we have grave concerns it will not accomplish this mission. Instead, this might make the issue of prescription affordability even worse by causing drug costs to increase for 64 percent of Ohioans—including those who rely on Medicare, private insurance or employer-based insurance—while reducing access to needed medications for the state’s most vulnerable citizens.

In particular for children’s health, the proposal does not address the question of access for children’s medicines in the Medicaid program.   The VA system is designed to serve a military veteran population.  The VA’s narrow drug formulary would not include specialty drugs for children and infants.  Because Issue 2 lacks any operational guidelines regarding how drugs not on the VA formulary are to be handled,  whether the state could continue to purchase those life-saving drugs —and at what price —are open to question.

As November 7 draws near, it is critical that our members understand the impact this proposed legislation could have on health care costs and access. Members can obtain more information by visiting, where reports have been written by three former Ohio Medicaid directors and a former budget director, and gather information on why over 70 organizations—including business groups, organized labor, doctors, nurses, pharmacists, hospitals, veterans and the faith community—are opposing this initiative.  Among those opposed include the Ohio Children’s Hospital Association, Ohio Hospital Association, Equitas Health, National Alliance on Mental Illness of Ohio and other health advocacy groups.

Upon reviewing Issue 2, we believe it is lacking the critical detail concerning access to medications for children and infants and could lead to more bureaucracy and excessive litigation costs. In addition, it could increase drug costs for those not covered by the proposal.

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