Missouri first state to vote on opt-out

By Andrew Denney

Saturday, July 3, 2010

Missouri voters will be the first in the nation to make their opinion of the federal health care law known at the ballot box.

On Aug. 3, voters will weigh in on Proposition C, which would amend Missouri law so individuals and employers cannot be forced by the federal government to purchase a private health insurance plan. The referendum, passed by the Missouri General Assembly, is intended to block a federal mandate requiring all individuals to purchase health insurance plans by 2014 or be fined.

If Missouri voters approve the referendum, there is some doubt as to how much power the state statute would have over federal law. Legislatures in four states — Georgia, Idaho, Virginia and Utah — have already passed laws similar to the one Missouri is proposing. Arizona, Oklahoma and Florida will leave it to voters to decide, with similar referendums in November.

The bill that created the referendum had originally been proposed to allow insurance companies to voluntarily dissolve with approval from the Missouri Department of Insurance. But that was amended to add language regarding the federal health care overhaul.

When filling in the circles on the ballot, voters will be giving either thumbs up or thumbs down to both issues at once.

The breadth of the two issues is one reason that Barbara Finch of St. Louis and Mary Brenner of Morrison filed lawsuits on June 17 against state leaders, said Chip Gentry, their lawyer. He said his clients also are concerned that their insurance premiums could be affected by the passage of the referendum.

Still, the vote could serve as a barometer of the mood in Missouri for the health care reforms passed by the Democrat-led U.S. Congress.

Daniel Radke, an adjunct professor of political science at Missouri Western State University, said more Democratic ballots are picked up by voters in Missouri in primary elections because many local races pit a Democrat against a Democrat without any competition awaiting them in November.

“This is the only election that counts in many races,” Mr. Radke said.

Because of this, he said, those filling out Democratic ballots in August should not be considered a monolith of support for “Obamacare.” The number of voters who consider themselves independent are increasing, and independents have shown less support for the law than partisan Democrats.

Mr. Radke, who said he is an independent, said he picked up a Democratic ballot so he could vote in an associate circuit judge race. He said he voted in favor of Proposition C.

But while Missouri might have an independent bent in its political culture, it’s the more partisan voters who show up for primary elections, said David Chilenski, a St. Louis political consultant. “People who show up for primaries are the most hard-core supporters of either party,” Mr. Chilenski said.

He predicted a “terrible” turnout overall — about 20 percent — and said he doesn’t see many partisan Democrats voting against the plan.

Mr. Chilenski also predicted the proposition would pass, as does Paul Hamby, the Missouri coordinator for Campaign for Liberty, a tea party group.

“It’s against everything this country is based on, which is freedom and liberty,” said Mr. Hamby. “I think Democrats and Republicans both have egg on their face.”

Regardless of the outcome, the state is already taking steps to prepare for changes that would be implemented by the law.

Federal money will be disbursed among the states to fund insurance pools for patients with high-risk status. Last year, the Missouri Health Insurance Pool, which serves about 3,600 policyholders, received most of its funding from fees paid from the policyholders themselves, said Travis Ford, a spokesman for the Missouri Department of Insurance.

Mr. Ford said Missouri would be receiving $81 million from Washington to begin a new pool, and the federal money will make up the majority of the funding. He said applications for the new pool would be available “sometime in July.”

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