BOSTON (AP) --After an expensive campaign that sharply divided health care professionals, Massachusetts voters have rejected strict limits on the number of patients a single nurse can care for at one time.
The ballot question would have established nurse-to-patient ratios in various hospital units and set penalties for hospitals that failed to comply.
The Massachusetts Nurses Association supported the question, while hospitals and doctors' groups opposed it. The two sides combined had spent more than $30 million to make their case to voters.
Supporters said the nurse staffing requirements would make patients safer, but opponents said it would create an overly rigid system that could result in hospitals being forced to turn away some patients.
California is the only other U.S. state with mandated nurse-to-patient ratios.
Massachusetts voters backed a commission to promote a constitutional amendment on corporate political spending.
Massachusetts voters have supported a state law that protects transgender people from discrimination in public accommodations, including bathrooms and locker rooms.
The yes vote on the ballot question Tuesday rejects an effort by opponents to repeal the 2-year-old law. It was the first statewide referendum in the U.S. on transgender rights.
Supporters of the law feared a vote to repeal would prompt a wave of similar efforts to roll back protections in other states. Massachusetts was the first to legalize gay marriage and is viewed as one of the most LGBT-friendly states.
Critics say the 2016 law allows sexual predators to invade private spaces for women by claiming female gender identity. No such incidents have been reported in Massachusetts since the measure took effect.
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