GENEVA — Some public sector retirees mulling over the potential impacts of a November ballot initiative to regulate prices for state-bought prescription drugs said they'll likely vote against it, simply because they feel the measure creates more confusion and uncertainty.

More than a dozen local members of Public Employee Retirees, Inc. met for lunch Friday morning at Best Friends Restaurant along South Broadway Avenue in Geneva. They heard from Mary Howe, head of the Ashtabula County branch of the League of Women Voters, on the pros and cons of Ohio's Issue 2, the Ohio Drug Price Relief Act.

According to the League, the initiative limits the amount the Ohio departments of Health, Aging, Medicaid, Job and Family Services, and Insurance can pay for prescription drugs. Those agencies wouldn't pay more than the lowest price paid by the U.S. Department of Veterans Affairs, which negotiates prescription drug prices and usually ends up paying at least 20 percent less than other agencies, according to the League.

The initiative affects about four million Ohioans who receive drugs paid for by the state. The majority of Ohioans who have their own private insurance, Medicare or another non-state provided insurance — about seven million people, according to the League — won't be affected, however.

"Specifically, (Issue 2) would forbid state agencies to enter into any purchasing agreement with drug manufacturers unless the net cost of the drug is the same or less than that paid by the VA," reads a guide released by the League.

But that "net cost" is one of the important terms left undefined in the initiative's current language, according to the League, along with others like "drug" and "state."

The issue is meant to address spiking drug costs, one of the main drivers behind rising health care costs, and could end up saving the state about $536 million a year.

But it doesn't address prices of drugs not purchased by the VA and could create "costly, complex" purchasing agreements, or lead pharmaceutical companies to respond by raising prices across the board, according to the nonpartisan League, which can only take stances on issues once it's done its research.

Retirees Jim Vandervort and his wife Christine, both Medicare Part D consumers living in Ashtabula Township, said they're paying more now for generic-brand prescription drugs than they did a year ago. They said they have a hard time believing any measure would lessen that burden.

"They're going to keep going up," Christine said. "Medicaid's going to go out and buy drugs cheaper, supposedly — so what? People like us are going to pay for that."

Jim said he'll vote no due to a provision that obligates the state to cover legal fees for the initiative's defense, should it come under fire.

In the case of retired public employees, it's still unclear whether the state's Public Employee Retirement System would be considered a state entity affected by the issue's passage — once Ohio releases public retirees' pensions to PERI, that money is technically no longer the state's money, Howe explained.

Furthermore, the prescription drug contracts negotiated by the VA are not public, so it's unclear just how much the issue's new purchase agreements would cost.

"It's a very confusing issue," Howe told those gathered Friday.

A very similar measure was defeated in California last year, 53 percent to 47 percent, according to California's Proposition 61 also exempted Medicaid-managed plans from the regulation, unlike Ohio's Issue 2.

Several state organizations have come out against the issue, including the Ohio Farm Bureau Federation and veterans groups like the American Legion and AMVETS — who fear their own prescription rates may spike with its passage, Howe said — as well as the VA itself.

The political advertisements for and against Issue 2 all sound the same to Jane Churchya of Ashtabula, who's also seen her prescription drug prices rise over the last year.

"They tell you vote no 'because,' and they tell you vote yes 'because' and it all sounds like the same reasons," she said.

Her daughter Denise, also of Ashtabula, is a Medicaid recipient who would be affected by the issue's passage. She also feels Issue 2 would end up creating more instability in the prescription drug market.

"I like to be informed, so I find something and I research the hell out of it," she said. "Everything I've found on Issue 2 just confuses me even more.

"So I'll probably end up voting no on it."

Follow Justin Dennis on Twitter @justindennis.