On November 8, voters in California rejected a proposition requiring the state not pay for any prescription drug from a drug manufacturer at any price over the lowest price paid for the same drug by the United States Department of Veterans Affairs (VA). With over 96.6 percent of the precincts reporting, 53.7 percent voted against the proposition and 46.3 percent voted for it, according to the California Secretary of State’s office.

Proposition 61, which would have created The California Drug Price Relief Act, applied to any program where the state agency is the ultimate payer for a prescription drug, even if the state agency does not itself buy the drug. The proposition exempted purchases of prescription drugs under managed care programs funded through Medi-Cal, which offers comprehensive health coverage to the state’s low-income residents. The managed care program serves approximately 75 percent of Medi-Cal enrollees. The proposition only applied to the fee-for-service system of Medi-Cal covering the remaining 25 percent of enrollees.

Opponents of the proposition argued drug manufacturers could decline to offer the state certain drugs sold to the VA or increase drug prices for the VA to reduce any decrease to profits.