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Voters in Massachusetts have grown used to weighty policy questions, from deciding whether to allow the death penalty or regulate abortion to whether to legalize physician-assisted suicide or create any number of tax-related changes.
2014 is no different.
Activists pushing seven ballot questions spent much of last year ensuring their proposals passed constitutional muster and collecting the tens of thousands of voter signatures needed to claim a spot on November's ballot.
Now comes the hard part - persuading voters to support their ideas. That effort can cost millions, depending on the question.
In 2012, the question that attracted the most spending would have allowed patients to self-administer life-ending drugs prescribed by physicians.
Of the total of $5.8 million spent on the question, $4 million was spent by the Committee Against Physician Assisted Suicide, much of it on an advertising campaign urging voters to reject the proposal. The question, which had the support of nearly two-thirds of Massachusetts voters in one poll, was narrowly defeated.
Other questions have drawn little advertising.
More than $1.1 million was spent in 2012 in support of a ballot question that would require Massachusetts to establish marijuana dispensaries for medical use.
Much of that money, however, was spent on collecting signatures. Without a well-heeled opposition to mount a campaign to defeat the measure, the question was approved by voters.
The questions heading toward the ballot this year include ones that would repeal the state's casino gambling law, raise the minimum wage and expand the state's existing bottle deposit law.
Other proposed questions would limit the number of patients assigned to a nurse at one time, require hospitals to be transparent about financial holdings, create a statewide earned sick time policy and repeal a new law linking future increases in the gas tax to the rate of inflation.
There is a shortcut.
Before landing on the ballot, the questions first head to the state Legislature, where lawmakers have the option of approving them or taking no action. In the latter case, supporters would need to collect a second, smaller batch of signatures to guarantee a ballot spot.
One measure that could be approved before it reaches the ballot is the minimum wage question that would raise the wage from $8 to $10.50 per hour over two years and link automatic future increases to the rate of inflation.
The state Senate has already approved an increase in the minimum wage from $8 to $11 over three years, also tying future raises to inflation. The House hasn't taken up the measure.
Most of the other questions are less likely to get legislative approval.
Backers of the question to expand the types of bottles covered by Massachusetts' bottle deposit law have been pressing lawmakers unsuccessfully for more than a decade to expand the law to include noncarbonated beverages like water, tea and sports drinks.
The question to repeal the state's casino law is even less likely to win the support of lawmakers, given that the process of awarding the casino licenses is well underway.
Unlike candidates for office, there is no limit on donations to ballot question committees, meaning that wealthy individuals can virtually single-handedly push a question.
That was the case with the medical marijuana question, which was bankrolled almost entirely by Ohio billionaire Peter Lewis, the former chairman of the board of the auto insurer Progressive Corp. Lewis died in November at age 80.
The most spent by competing sides on a single question was $13 million for a 2006 effort to sell wine in food stores. That question failed.