I am not sure how PieFed does it. I hope someone more familiar with the actual protocol can shed some light.
What is important here is whether private votes from the same profile are associated with the same voter ID. PieFed accounts have two subaccounts, a public posting account, and a private voting account. When voting on a Lemmy post, the anonymous voting profile is used. There are multiple ways to do this:
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(the way your post assumes) Assign a unique ID x to every voting profile, and every vote by the same ID x gets tagged with x. This is easily traceable, like you said. Even if auto-upvoting of one's own posts is not done, one can still gather a lot of information about the voter.
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Do the same as 1, but, do not tag the vote directly with the voter's ID x. Instead, encrypt/hash the ID x so that the voter ID tag is different for every vote, but could be decrypted by the hosting instance to get the original ID x.
From my understanding, it is 2. 2 is better for privacy, with a caveat. Admins would still have the ability to deanonymise private voting IDs.
The article fucked it up. The bill (first version) says: "Section 8 of this bill establishes the maximum ratios for the number of patients that may be assigned to a direct care nurse at one time in certain hospitals in a county ... ".