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“The RMV already handles cases of people who are eligible to drive but not vote — including lawful immigrants with green cards and new drivers under 18,” the report states.

The Tufts reports said insurers may actually lower premiums and streamline administrative functions, or cut profits. They might also begin covering more procedures which would allow dentists to charge higher prices.

“There is this kind of trust question,” said Evan Horowitz, the center’s executive director, “not just in people you vote for today but people you envision [voting for] in the future.”

A study from Tufts University's Center for State Policy Analysis said that the change would generate about $1.3 billion of revenue in 2023 and would apply to about 0.6% of households in the state.

“Whatever voters decide on Question 3, the broader fight over alcohol sales in Massachusetts is likely to continue, with more expansive ballot questions in the years ahead,” said Evan Horowitz.

The money—about $1.3 billion in 2023, according to a Tufts University estimate—would go to education, roads, bridges, and public transit...About 0.6 percent of Bay State households would pay the surtax, according to Tufts.

A $1,000 tax credit, given out to some 3 million eligible households, would also mirror the $3 billion figure certified by the state auditor, Horowitz said.

The report by Tufts University’s Center for State Policy Analysis concluded that while the ballot question clearly states that the money must be devoted to education and transportation, not all the surtax revenue is likely to be spent in those areas.

Evan Horowitz, who reviewed these documents for Axios, says budget analysts faced a complex "accounting game" before June 30 because of the automatic tax refunds.