Groups that support and oppose the ballot questions set to appear before voters this November have raised more than $14 million combined, and they’re expected to raise and spend millions more in the next several weeks leading up to Election Day.

Question 1, which would limit the workload for hospital nurses, has drawn the most money of the three questions, according to new reports filed with the Massachusetts Office of Campaign and Political Finance.

A Massachusetts hospital industry group has raised more than $7.2 million to try to defeat the question. The group in favor of the question, led by the Massachusetts Nurses Association, a prominent labor union, has raised about $4.7 million.


Question 1 would set restrictions on the number of patients assigned to one nurse at a time. The union argues that nurses are overburdened and that patient limits are necessary to improve care. Hospital leaders argue the measure would be extraordinarily costly and would force them to cut back on services.

“The big money is in Question 1 — on both sides,” said David A. Hopkins, a political science professor at Boston College. “Like any political campaign, money helps. But it doesn’t alone determine the outcome.”

Question 3, which seeks to repeal certain protections for transgender people in Massachusetts, is also shaping up to be an expensive political fight. A “yes” vote on the question would maintain the state law that allows people to use the restrooms and locker rooms that match their gender identity and protects transgender people from discrimination in public places like malls and restaurants.

The coalition urging voters to keep the antidiscrimination law has raised almost $2.2 million since 2016, far outpacing the roughly $133,000 raised by the group that wants to repeal the law, according to campaign finance reports.


The “yes” coalition, which includes large employers, has reserved television air time and plans to run ads closer to Election Day.

“We’re feeling great momentum,” said Matt Wilder, a spokesman for the coalition, known as Freedom for All Massachusetts. “We also know we can’t take anything for granted. . . . The opponents are pretty persistent, unfortunately.”

Opponents of the transgender antidiscrimination law say it is overly broad and allows male predators masquerading as transgender women to enter women’s restrooms. In a statement, the opponent group, called Keep Massachusetts Safe, criticized the “yes” coalition for taking out-of-state money and said it will focus on “grass-roots volunteer efforts” to make its case to voters.

Supporters of ballot Question 2, which pertains to election spending, raised only about $187,000 in 2017 and 2018. That question, if approved, would create a commission to consider and recommend potential amendments to the US Constitution to establish that corporations do not have the same constitutional rights as people and that campaign contributions and expenditures may be regulated.

So far, the issue of patient-to-nurse limits has been the most bitter and expensive ballot question. The question would set limits on patient assignments based on the severity of the patients’ medical conditions.

The nurses union-backed Committee to Ensure Safe Patient Care, which brought forward the ballot initiative, drew most of its money from the nurses union and other labor unions, which are funded by member dues.

“The money that comes from unions is coming directly from working families,” said Kate Norton, a spokeswoman for the committee. “We’re proud of all the support we’ve gotten.”


The hospitals-backed Coalition to Protect Patient Safety is funded almost entirely by the Massachusetts Health & Hospital Association. Only $1,000 came from another group, the Organization of Nurse Leaders, which represents nurse executives.

“Educating every voter across the Commonwealth takes resources,” Dan Cence, a spokesman for the hospital coalition, said in a statement. “We are using these resources to reach voters through broadcast and cable television, radio, social media, door-knocking, phone calls, as well as visiting every hospital in the state to ensure that voters are aware of the massive consequences to Massachusetts’ health care system should Question 1 pass this November.”

Both sides have been spending on consultants and television ads.

While hospitals have the fund-raising advantage over the nurses union, both sides will have to compete with high-profile political races to get their message across to voters. The statewide governor’s race and US Senate race are likely to take up coveted television air time closer to the Nov. 6 election, said Boston communications consultant Joe Baerlein.

“That puts more pressure on these ballot campaigns as to how much they will be able to get on the air,” said Baerlein, who has worked on ballot campaigns in the past. “The competitive advantage on money — I would rather have it. But in this particular cycle, I’m not sure you’re going to be able to spend it all on television.”


Joshua Miller of the Globe staff contributed to this report. Priyanka Dayal McCluskey can be reached at priyanka.
. Follow her on Twitter @priyanka_dayal.