Early voting began Monday when the 4-3 ruling was placed, so it is too late to remove the measure from the ballot. Instead, the court has ordered election officials to ignore all votes cast for it. The constitutional amendment would have provided more qualifying conditions for a medical cannabis prescription, expanded the definition for medical professionals that can provide patients with a medical marijuana prescription, and made medical marijuana cards valid for three years instead of one year.

The state Supreme Court ruled the proposed amendment was misleading in not informing voters that the legislature’s ability to change the 2016 constitutional amendment would have been removed. Also, the measure did not detail that the amendment would legalize up to an ounce of marijuana possession for any purpose if the drug became legal under federal law.

“This decision doomed the proposed ballot title, and it is plainly misleading,” Justice Shawn Womack wrote in the majority opinion.

In a dissent, Justice Cody Hiland said the court was making an unprecedented decision by finding the measure’s wording misleading.

“Long ago, this court established definitive standards for evaluating the sufficiency of popular names and ballot titles,” Hiland wrote. “This court has not deviated from those standards until today.”

In a split ruling, the court also rejected Secretary of State John Thurston’s decision in September that the measure failed to have the required amount of signatures to be put on the ballot. Arkansas for Patient Access, the group sponsoring the bill, sued Thurston in the Supreme Court to allow the amendment to get on the ballot.

Project Arkansas Kids is the group that initially raised concerns over the proposed amendment’s ruling, intervening in the court case. In a statement, the group called the court’s ruling “a tremendous victory for public health and safety.”

Arkansas for Patient Access said the signatures it gathered proved voters’ support for the amendment, saying it had more than 150,000 signatures from all over the state.

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“Today, the politicians ignored their requests. This is a setback for the growth and improvement of our existing program, but it will not be the last attempt to ease the barriers Arkansas’s medical patients encounter,” the group said in a statement Monday. “It seems politics has triumphed over legal precedent.”

Now, only Nebraska will have medical marijuana proposals on the ballot, and Florida, North Dakota, and South Dakota will be voting on whether to legalize recreational marijuana for adults.