This week on Face the State, Arianna Bennett interviewed Josh Hicks, Alliance to Stop Taxes on the Sick and Dying in favor of ballot Question 4. For the opposition, the person who wrote the rebuttal and argument against passage on the ballot is former Nevada State Senator Ann O'Connell who said she would not speak on camera. For the final segment, discussing all of the ballot measures and a few key races is TMCC Political Scientist, Fred Lokken.

Read the full transcript below or watch the interview in the video player.


Arianna Bennett: Welcome to Face the State, I'm Arianna Bennett. Thank you for being with us. Nevadans will be deciding on four statewide ballot questions this election. For this episode of Face the State we take a look at ballot question 4, the Medical Patient Tax Relief Act

Question 4 asks, "Shall Article 10 of the Nevada constitution be amended to require the legislation to provide by law for the exemption of durable medical equipment, oxygen delivery equipment, and mobility enhancing equipment prescribed for use by a licensed healthcare provider from any tax upon the sale, storage, use, or consumption of tangible personal property.

Here's what that means: in Nevada certain categories of goods are exempted from the sales tax so if you buy food or medicine for example you don't pay sales tax on it. But medical equipment like wheelchairs or oxygen machines aren't included on that list even if they're prescribed by a doctor. This measure seeks to secure an amendment to the Nevada constitution which would make this type of medical equipment exempt from sales taxes when it is prescribed by a doctor. If this measure passes this year it will have to be voted on and approved again in the next election in order to take effect.

Now as with the other three statewide ballot questions I'm featuring on Face the State this campaign season I looked for those in support of and against this measure to bring them here on the show. Now the goal here on Channel 2 and on Face the State is always to bring you every angle of an issue. In this case I hadn't heard from or been able to find any group in opposition. I reached out to the Nevada Secretary of State's office which organizes elections and was told by the Deputy Secretary of States for Elections Wayne Thorley that he wasn't aware of any organized opposition to this measure. I later learned that the person who wrote the rebuttal and argument against passage which you'll see on the ballot is former Nevada State Senator Ann O'Connell. I reached out to her to see if she would be willing to come on the show to explain her argument against Question 4. She told me she would not speak on camera and hung up on me when I asked for further explanation. So in this episode you will hear from the party advocating for passage of Question 4 but if there is an organization or group opposing this measure, I urge you to contact me. We would love to hear your side of the argument.

Now finally I feel it is important to disclose that while I am in no way involved in campaigning for or against any ballot measure I am related to one of the backers of Question 4. So stay tuned we will be back to hear from proponents from the measure and the concerns raised by the argument against on the ballot right after the break.


 Arianna Bennett: Welcome back to Face the State, we continue our discussion of Nevada Ballot Question 4 The Medical Patient Tax Relief Act. Now Josh Hicks with the Alliance to Stop Taxes on the Sick and Dying is here now to discuss the measure. Josh, thank you for coming on the show.

Josh Hicks: Thank you for having me.

So you are with the organization working to get this passed. Tell me generally why the organization is for it? Why are they pushing it?

This is an issue that has kind of come to a head recently but it has been in the state for quite a while. It goes back several decades. There was a Supreme Court case in 1990 that dealt with this issue of sales tax on medical equipment and oxygen delivery equipment and it actually held that that equipment was exempt but that case itself was actually an unpublished case and as a result it wasn't necessarily widely known. So over several decades there was confusion among the industry about this and as that has started to come to a head with the tax department everybody started realizing there was an issue here, there was a difference of opinion on whether there's an existing exemption or not and this ballot question arose out of that. This was an attempt to actually just make it crystal clear by putting it in the Nevada Constitution that these types of items are in fact important medical equipment for needy people and therefore should be exempt from the sales tax.

So for how long have Nevadans been paying sales taxes then on-on this type of equipment?

Well it's a good question and it's hard to ask that very definitively because there was a period of time in 1990 where even the taxing authorities had promulgated their own policies and procedures saying this was exempt from tax. There was an internal change of position at some point in the late 90s or early 2000s and we don't know exactly because taxpayer records are all confidential, we don't know exactly how much was at stake but the tax department started enforcing that and saying sales tax is actually due on those kinds of equipment and that led to some of the industry members getting together rather than having their patients pay this kind of tax and seeking an exemption in-in by the ballot question.

Why is a sales tax on this type of medical equipment a problem in your mind?

It's-this is something when you look at these kind of - this kind of equipment, this is important equipment for people who have serious health problems. These are people who have respiratory issues, potentially life threatening issues, people who are in seeing doctors, they have enormous medical bills. Many of these people are older people who are on fixed incomes and the-this equipment can be very costly and even if it's covered by insurance the sales tax is not and that's-that's where it becomes an out of pocket expense for these people. So as our population gets older and as we have more people on these kind of-this kind of equipment it becomes more and more of a burden for people.

Now this isn't the first time this conversation has come up. In the last legislative session there was a bill which ended up dying in the Assembly which would've have exempted certain medical equipment like this. That measure failed. Why a ballot measure now? How is it different and why-why should it pass when that measure failed?

So there was-there was a measure last session it was called Senate Bill 334 and it had an exemption not just for this type of equipment which our ballot question addresses, which is oxygen equipment, durable medical equipment, and mobility equipment, but it included eyeglasses, contacts, hearing aids and because of the inclusion of those it was a much larger exemption and it ended up being around a $20 million dollar or so fiscal impact on the state. Now on the Senate side that did not bother the Senate, they actually passed it unanimously. So it was a bipartisan passage of that bill. Then it went over to the Assembly side and I think it was actually getting, it had the hearing with the money committee on the Assembly side  I'd-I'd observed that myself and I think the main concern was the size of that fiscal note. The fiscal impact was rather large and like I-I say it was mainly because of the eyeglasses and contacts that made it that way. As the session was running out of time near the end it just became logistically difficult to amend the bill to try to get it down to something more measurable. The clock ran out on the session and that was the end of the bill. So there was no actual vote on the Assembly side, it just ran out of time and didn't get out.

Okay. Now this also does have a fiscal impact but on the ballot it says specifically that it cannot be determined how much of a fiscal impact. So you guys are kind of asking Nevadans to blindly approve something when they don't really know how much affect it's going to have on the budget right?

I wouldn't say blindly because even though the legislative counsel bureau said they couldn't determine the fiscal impact there were fiscal notes put in on Senate Bill 334 and those fiscal notes broke it down by the different items. So they actually did a fiscal analysis of what it would mean for the oxygen delivery equipment, the durable medical equipment, and the mobility equipment and that was about $900-thousand dollars a year. So we feel very strongly that that is an accurate projection of what the exemption would be. And when you look at 900 million dollars a year in about a 3.5 billion dollar annual budget -

(interrupting) Wait 900-million or 900-thousand?

900-thousand, thank you, sorry. 900-thousand in a 3 .5 billion dollar budget that's not a lot of money. It's a very small piece of it. That's something in the legislative building you call that budget dust. It doesn't have a huge impact on the budget. We have cities like Las Vegas in Nevada calling that a nominal impact in their fiscal notes and largely unconcerned about it. But at the same time that's a very big impact on people who are on fixed incomes paying a couple hundred dollars in sales tax can be a real big issue for those people so a big impact on those people not really a big impact on the state budget.

Okay some of the concerns raised by the arguments against are that the wording in the ballot measure for example is vague and there's no way of knowing when this goes to the legislature to be written up what it will eventually look like. Is that truthful?

I don't think that's a valid criticism because for one thing several of these terms already are defined in Nevada law. Durable medical equipment is a defined term, mobility enhancing equipment is a defined term, those are both in regulation. Oxygen delivery equipment is a commonly used term in tax law throughout the country including in some states that have very similar tax constructs to ours. And the bill- this bill- this question itself actually requires some legislative involvement. It requires the legislature to actually put the specifics on this. So any questions about what something actually means those can get still hashed out at the legislative level unanswered because it is important to have certainty in tax policy and this principal would make this exemption, the legislature can utilize existing terms, they can fill out any other blanks that they need to fill out and then we'll have a nice clean understandable exemption for people to look at.

Is it possible then that when it goes through that process that it might look different from what voters are voting on in November?

Not significantly. There are just you know some questions that they may answer, they may want to define oxygen delivery equipment for example because that is an undefined term in Nevada law. But I don't think-I don't expect there will be anything major to it. It's a very straight forward change and it's in the con-it would be in the Constitution so there would be a mandatory exemption for it.

Okay. Now your main argument is that this is a huge benefit to patients, will it also be a benefit to the businesses that sell this equipment though?

It will. I think you know right now things can be a burden on those on those businesses. Accounting and taxes for medical equipment is difficult, especially with the way insurance works because you don't always get paid when you're in these businesses until down the road. Then you get a reimbursement that may be set by contract. Many times the tax can't be included in that. You've got difference-differential treatment with businesses right now if it's a Medicare or a Medicaid sale or a non-Medicare Medicaid sale it creates tremendous administrative difficulties for them to do that and the way our law works, if a business does not actually collect the tax from the customer and that's how our sales tax works, we collect it from the user but if a seller, if a reseller, or provider of this equipment does not actually collect that if they just can't collect it or they-they don't get it in the billing process it becomes their liability so it can actually hit the business and then the business has to deal with it. These are businesses that are already hit hard by changes in federal healthcare insurance laws and they see their profits going down all the time so this is one more thing that they have to deal with as well.

Okay, now in the argument against it also said this is asking for special treatment for a group they called a special interest group. What's your response to that?

I don't think this is a special interest group at all. We have many exempts to sales tax in our law, you mentioned in your introduction food is an exemption that's been in there, medicine is an exemption as well. Usually we have exemptions for a good reason, that's something because it is a section a segment of the population that we don't want to have this burden on. And this to me is right in line with the medicine exemption. These are important life saving pieces of equipment you know they're everything from the C-Pap machines the oxygen tanks, infant apnea monitors, these are things that save peoples' lives so they're things that we should encourage an exemption on and many of our states in this country we're in the very small minority who have a sales and use tax system that actually tax this kind of equipment. Most states do not. The vast majority do not and we should join those other states.

Okay well we have a minute or so left, so what is your what's your final message to voters? What do you want them to take away from this?

I think the message is to put Nevada on track with other states, let's treat things consistently. Let's think about the population that can really benefit from these kind of exemptions and let's enact some fair and clear tax policy to help those people out.

Okay, Josh, thank you so much for your time I sure appreciate it.

Thank you Arianna.

Well coming up on Face the State we will analyze all four statewide ballot measures with a political scientist. Stay with us.


Arianna Bennett: Welcome back to Face the State, I'm Arianna Bennett, thank you for staying with us. Well over the last month we've featured every statewide ballot question that voters will be facing on election day: gun background checks, recreational marijuana, energy deregulation, and medical equipment taxes. Now we'll take a look at where Nevadans stand on these issues, how likely they are to pass, and which big races we should be watching. TMCC political scientist Fred Lokken is here now with me to talk about that. Fred, thank you so much for coming on the show.

Fred Lokken: Thank you for having me.

All right we're talking ballot questions. Now I think often these kind of fly under the radar in elections, this election in particular has had so much media circus around the presidential, do you think people are paying close attention to the ballot questions this time around?

Well they should be. I mean honestly these are probably some of the most interesting ballot issues that Nevadans have had to consider. However I completely agree with you and I think that there has been a real adverse affect down ticket. Most everyone has either just completely forgotten about the other races or they have moralists been so turned off on the national issue they're just not even thinking about voting this year and I think for a variety of reasons candidates are very frustrated because they're just not really making the connections, they're not really feeling the passion or interest that we would have found in a normal election cycle.

Do you anticipate us having a record low turn out this time around?

Well it would be hard to beat 2014, that was a 77 year low but (Bennett laughs) you know we strive to be at the bottom of the turnout factor. A lot of people are indicating to you know contrary to hopes that we might see a surge that we probably will not be too surprised to see a very low voter turnout. To begin with you have a 20% non partisan in Nevada, that's huge. And the non partisans are the ones that are sort of stuck on the fence of trying to decide which way they might go say in the presidential selection for a variety of reasons. There's a feeling that here in Nevada and nationally a lot of them may decide not to vote and that will have real down ticket implications. So are - we do know that at-at this taping the Washoe County Registrar is seeing a last minute surge in registrations which- but many of them she thinks are convinced that there might be some shenanigans, some fraud going on and they I think they want to be registered so that they can monitor so it may be I-we'll have to wait and see if that has any impact on the vote.

Hey whatever gets more people registering (laughs) is a good thing I guess.

Especially in Nevada.

Okay so let's talk about these specific questions. Question one is gun background checks. An interesting one, there was a recent Suffolk  poll that had it actually passing in Nevada with 66% support, that was a few weeks ago though so what do you think is going to happen with this one?

Well as you well know most of the advertising has kind of bantered back and forth on this. I think if you go on the basis of the ads you’re going to be a little bit confused about what the right answer is for this. We know that Bloomberg out of New York has-has devoted as much as $5 million of his own wealth into trying to get this passed in Nevada so voting in favor. It is one of the ballot issues that was basically put here on purpose from outside the state of Nevada and I never like that. I really don't feel like we should be the guinea pigs for something else. The logic being that if it could pass in Nevada they'd have a better chance elsewhere in the United States. So I do agree that the poll data suggests that it gets back to the issue of who shows up on election day and in the ten day early period for Nevada because if we see more of a democratic party surge in Nevada this time around that may bode you know better for it. If we see people stay home then we could actually see it fail.

Hm, interesting. Okay Question 2, recreational marijuana, this one has probably gotten the most attention out of all of the ballot questions, really interesting. And I was surprised to see on that same poll it had 57% support despite what seems like this big surge in opposition from a lot of local leaders. Where do you see this one going?

Well the opposition got organized a little late which frankly may have had some impact on-on the success in stopping it. And within context, this is on the ballot in California as well. So you-there is sort of a feeling that again it could be driven by a party of republicans perhaps less interested in supporting it than democrats. So if we see a democratic uptick for this November election that would speak well for both Ballot 1 and Ballot 2. The general consensus that it passes maybe more narrowly than they anticipated but right now it doesn't look like it goes down to defeat.

Interesting. Okay Question 3, energy deregulation. This is a complicated one that I feel like most people at least who I've spoken to don't have a real firm grasp of what it would mean which kind of leads me to wonder if people will vote on it at all? What do you think?

Well that's it. And we haven't seen the sample ballots yet to know exactly how effectively they explained this but 16 states have passed this type of-of an initiative and it it's not exactly a deregulation it's-it's an opportunity for increased competition in electricity delivery. NV Energy remains our purveyor, it's the one that has the power lines. But other companies could come into the state and become alternative sources for people who want to buy their electricity from someone other than NV Energy. It's been pointed out for instance you might find cheaper rates from some of the competition but you may even be willing to pay more because you'll be told it's clean energy that you're on and that philosophically may be important. Some suggest-this has to go through two ballots to actually be approved so this is the first run. And the backers of this are pretty well convinced this will be resolved in the state legislative session next spring that if it passes the first round there will be a bigger appetite to just do something where they have more legislative control over it.

And that's actually the case for-for Question 4 as well. It's also a constitutional amendment which would have to pass two success able actions and be then written up by the legislature in the same way. What do you think about that one? That one I know has actually gotten the least attention I think.

Well and when you look at it it's kind of like a duh moment. I mean you're removing sales tax from medical equipment. They tried in the-in the 2015 legislative session and-and it didn't succeed. This is their plan B. They honestly believe that you know people that need it most would really benefit from removing the sales tax. It's tragic in a way that they have to go through this long journey but since they couldn’t get the legislature to really pass it I honestly have no way of knowing how voters - I don't even think it's been tested in any of the surveys.

(Bennett) It hasn't no.

It's just one of those non-issues that will be flying under the radar on election day.

Yeah. I think it is interesting. Now what was interesting to me about that in the legislature is that it actually did pass one house unanimously and then just died without a vote in I believe the Assembly. So it actually had a lot of support it was just one of those 'deadline ran out' and it fell off the radar.

Timing is everything in the Nevada State Legislature. In 2015, more so. So we-we saw a number of very practical pieces of legislation not get through and some very odd ones did get through so you know it was one of those years.

It is always interesting to watch what happens. Now what I hear sometimes from people about ballot questions in general is that they don't like voting for them because they think it makes bad policy or that it's too difficult to change after it's been passed through the ballot. What do you think of that?

I agree entirely. This is not the way a democracy is supposed to work. It's predicated on a significant distrust of the political process that you have. Although we've-we've had some surprising numbers of ballot initiatives. California is the study on steroids. I mean I think they have 18 this election season. And I feel sorry for voters trying to make sense out of that. I mean basically you don't need government if you want to try to do everything by ballot and the problem is that for most voters you don't have the time to really understand and grab the background, the implications of a background check policy or the implications of recreational marijuana. In my mind it's always better left to the legislature and to the process of staff that can provide you know better background and understanding. But in the west where we do distrust government is where initiatives live and flourish.

All right now going a little further up the ballot obviously  the race that everyone's going to be watching across the country really is the senate race to replace Harry Reid's seat. They have been neck and neck, Catherine Cortez Masto and Joe Heck, in just about every poll or at least in the margin of error. What's your prediction?

Well this is back to 2010. It was neck and neck with Sharron Angle and Harry Reid and everyone was very surprised when Harry Reid won by 6.5% points. It reminds us that polling in Nevada is an iffy business and that in our elections we are always razor thin. This is why we are in the national limelight all the time. But this is the number one senate race, everyone will be watching. My-my guess is that we will see a democratic surge and Masto will benefit from that. We have the highest number of democrats registered in the- in Clark County ever and they have almost 140-thousand edge over republicans just in Clark County. So if democrats show up on election day, that's gonna matter.

And it of course all depends on what goes on in peoples' minds with the presidential election. Hillary Clinton's been really pulling ahead a lot in pretty much every poll the gap is widening. Do you see Donald Trump being able to close the gap at all?

I honestly don't think so. It would be unprecedented. It is an unprecedented election so I guess anything is possible but conventional wisdom would tell us that that had to be happening probably about four weeks ago and with no ground game, so no one to really rally and be doing things that might turn the corner, I don't think you can do it from the top down. So I think he is in a very deep hole at the moment with a momentum that seems to be shifting towards Hillary Clinton.

Now we have a few minutes left, I think that being said regardless of who wins the presidential election it's kind of exposed a lot of deep divides in our country that maybe people, I know I didn't really realize were there before. How does the country move forward from this in a productive way after such a negative, divisive campaign season?

Well from a party perspective to begin with I think the democrats are in a better place. No one had anticipated this run by Bernie Sanders to be so effective and it-it really did seem to be driving a wedge in the Democratic Party. But the Democratic Party worked the way American parties have worked in the past. After the convention it came together and you see you know Bernie Sanders coming to northern Nevada to campaign for Hillary Clinton. You see every other member of the democratic family out there doing it. The same cannot be said about the republicans. They have-they have suffered a major trauma in this election and many of us wonder about what November 9th looks like for the Republican Party. Does it survive this? Does it go away? Does it splinter into more than one party by 2020? Who will become the leaders after such a damaging year for the party?  And none of us have the answers, only time will tell. But it's kind of frightening because we do need a viable two party system to sort of keep each other honest and to keep this republic moving forward.

Yeah. Okay well we are out of time but Fred thank you so much -

(interjecting) Thank you so much for having me.

- appreciate you taking the time once again. Now that is it for this episode of Face the State but for more information on all of this  or to see the past episodes including all the things we've done on the ballot questions just can head to our website that's Thank you for being with us. We'll see you next week.