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Missouri Healthcare Freedom, Proposition C (August 2010)

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The Missouri Health Care Freedom, Proposition C was on the August 3, 2010 statewide ballot in Missouri as an legislatively-referred state statute, where it was approved Approveda. The proposed measure aimed to block the federal government from requiring people to buy health insurance and banned punishment for those without health insurance.[1][2][3]

Backers of such measures were opposed to President Barack Obama’s new health care plans. The measure did not advocate a particular plan but measure advocates said the measure would "protect the individual’s right to make health care decisions." Opponents of the measures and some constitutional scholars said the proposals were mostly symbolic, intended to send a message of political protest, and had little chance of succeeding in court over the long run.[4]

On May 4, 2010 the Missouri State Senate voted 26-8 in favor of referring the proposed measure to the ballot.[5] On May 11 the House gave final approval to refer the measure to the ballot following a 108-47 vote.[6][7][8]

Although similar measures were scheduled to appear on other 2010 statewide ballots, Missouri's Proposition C marked the first time voters had a say on blocking the federal government's 2010 health care reform.[9]

A "yes" vote was a vote to amend current Missouri law to deny the government authority to "penalize citizens for refusing to purchase private health insurance or infringe upon the right to offer or accept direct payment for lawful healthcare services." A "no" vote was a vote to reject the proposed referendum.

Reports out of Missouri predicted a low turnout of voters on August 3, as there were no television advertisements or debates on the matter in the low-key campaign. The Missouri Secretary of State expected a voter turnout of 24 percent.[10]

Election results

Unofficial election results follow:

Proposition C
Result Votes Percentage
Approveda Yes 667,680 71.1%
No 271,102 28.9%
Total votes 938,782 100.00%
Voter turnout N/A%


3354 of 3354 precincts reporting

Unofficial election results via the Missouri Secretary of State's website.

Text of measure

See also: Full text of the measure

According to the Missouri Secretary of State the official ballot title read:[11]

Official Ballot Title:

Shall the Missouri Statutes be amended to:
  • Deny the government authority to penalize citizens for refusing to purchase private health insurance or infringe upon the right to offer or accept direct payment for lawful healthcare services?
  • Modify laws regarding the liquidation of certain domestic insurance companies?
It is estimated this proposal will have no immediate costs or savings to state or local governmental entities. However, because of the uncertain interaction of the proposal with implementation of the federal Patient Protection and Affordable Care Act, future costs to state governmental entities are unknown.

Fair Ballot Language:
A “yes” vote will amend Missouri law to deny the government authority to penalize citizens for refusing to purchase private health insurance or infringe upon the right to offer or accept direct payment for lawful healthcare services. The amendment will also modify laws regarding the liquidation of certain domestic insurance companies.

A “no” vote will not change the current Missouri law regarding private health insurance, lawful healthcare services, and the liquidation of certain domestic insurance companies.

If passed, this measure will have no impact on taxes.

Support

YesMOPropC.jpg

In May 2010 media reports said that local consultant Patrick Tuohey filed paperwork to establish a committee in support of the proposed health care freedom measure.[12] The official group in support of Proposition C is Missourians for Health Care Freedom.[13]

Arguments

  • Sen. Jane Cunningham, a sponsor of the proposed measure, argued that the measure was about protecting personal liberties and allowing Missouri residents to choose whether to accept federal health care without any penalties. "Missourians will lose absolutely nothing if this amendment passes. They can choose the government plan or they can choose anything else they want," said Cunningham. But some lawmakers argued that the health care legislation crosses into states' rights and oversteps its own federal power. Sen. Jim Lembke said,"If the federal government is going to make all the decisions for us, why are we here?" [14]
  • In a July 25 blog post, the Citizens Commission on Human Rights of St. Louis said, "We think voting for this is a good idea because the recently passed federal Patient Protection and Affordable Care Act is laden with language and funding for the psycho/pharmaceutical industry, which has a vested interest in seeing every man, woman and child in America labeled with some mental disorder and prescribed harmful psychiatric drugs."[15]
  • Carl Bearden, executive director of United for Missouri, said, "Quite simply, United for Missouri believes that the federal health care package pushed by the president and supported by the Democratic Congress treads on states' rights. It's a mandate on individuals and states that goes beyond proscribed federal powers."[16][17]
  • A co-sponsor of the proposed measure, Rep. Ed Emery, said, "It’s unsustainable anyway, but it’s more quickly unsustainable if you can get out of it," of the 2010 federal health care reform. In regard to the proposed measure, Emery said, "This is the most fundamental Constitutional battle. We have, little by little, been losing the principles of federalism. This is our chance to take a stand and make America like America is supposed to be."[18]

Donors


Senator Jane Cunningham on Prop C, Part 1, 7-17-10

According to the quarterly finance report filed July 15, Missourians for Health Care Freedom received several donations from June 18 through June 30. According to reports, the group received $22,768.07 in monetary contributions.[19] According to the finance report, the group has had a total of $9,700 in expenditures.[20]

Below is a chart that outlines major cash contributions to Missourians for Health Care Freedom:[20]

Contributor Amount
Citizens for Brad Lager $5,000
Missourians for Goodman $5,000
Ray Vinson, Executive for US Auto Protection $5,000
William Canfield, retired[21] $5,000
Fred Sauer, Orion Investment Co.[22] $5,000
Missourians for Mayer $2,500
Ron Richard 2010 $2,500

Campaign advertising

The Missourians for Health Care Freedom began running radio ads on July 26 in support of the proposed measure. According to reports, the radio ads ran during conservative talk shows and on Christian radio stations.[23]

Tactics and strategies

In the last week prior to the August 3 primary vote, supporters held various rallies and fundraisers. On July 28, 2010 Missourians for Health Care Freedom held a fundraiser/rally at The Columns Banquet Center in St. Charles, Missouri. According to the campaign's website, attendees included Sen. Jane Cunningham, Sen. Jim Lembke, Rep. Tim Jones and Rep. Brian Nieves.[24] Another fundraiser is scheduled for July 29 and a rally is scheduled for July 31 at the corner of Brentwood and Manchester between 12 and 2 pm.[25]

Opposition

NoMOPropC.jpg

Opponents argued that the approved federal health care legislation was similar to a mandate, requiring lawmakers to cover treatment for autistic children - approved in March 2010 by the Missouri State Senate. In response to supporters' arguments Sen. Victor Callahan said, "Social Security per se is not in the Constitution. I don't see it in the Constitution but it appears to be on my check every two weeks."[14]

Arguments

  • On July 23, 2010 the League of Women Voters of Missouri came out in opposition to Proposition C, arguing that, "The new federal law, the Patient Protection and Affordable Care Act, provides universal coverage with access to affordable, quality care for all Americans . . . Proposition C undermines a key component of the law by allowing Missourians to opt out of buying health insurance without having to pay a penalty. League opposes this proposal."[27]
  • On July 24, 2010, the Missouri Hospital Association urged voters to consider that, "Proposition C would only reinforce a broken system." The Association suggested that Missourians should consider that it was, "unfair for Missourians who pay for health insurance to pay higher insurance premiums to cover the cost of care for those who decide not to buy insurance."[28]
  • Ruth Ehresman, the director of health and budget policy for the Missouri Budget Project, wrote in an editorial, "A 'no' vote on Proposition C will allow Missouri — and the rest of the nation — to focus on planning how to implement federal reform well and how to improve parts that might need changing. Those wishing to make political statements should be careful to not do it at the expense of the estimated 500,000 Missourians who will gain access to affordable health insurance through federal reform. Voting 'no' on Proposition C is a wise choice."[29]
  • Brian B. Zuzenak, the executive director of the Missouri Democratic Party, made the argument that the measure would change nothing and was a waste of the state's time. According to Zuzenak, “The proposition will have no legal standing, so I don’t know why there’d be a reason to focus on it. From the beginning, we’ve said it’s meaningless and unconstitutional. At best, it’s a ploy by the Republicans to get their base excited.”[10]

Donors

The Missouri Hospital Association spent more than $400,000 sending out fliers opposing the proposed measure. Eliminating the federal health insurance mandate in Missouri would reduce the number of residents expected to obtain health coverage, according to the MHA. This would negatively hurt hospitals because they would receive lower payments designed to fund higher levels of coverage. [30][31] [32]

Campaign advertising

On July 26 opponents of the proposed measure began running radio ads calling for voters to vote "no" on Proposition C.[23]

Tactics and strategies

Opponents of the proposed measure and supporters of the approved federal health care reform created a group on Facebook called "Vote No on Missouri Prop C." The group, however, did not list an official website. According to the group's logo, the motto read, "Protect Health Care For All Missourians: No! on Prop C."[33]

A blog was created on blogger.com called "Vote No Prop C in Missouri." The blog highlighted a rally, scheduled for July 29th at 5 pm. The rally was scheduled to be held in Kansas City, Missouri at the intersection of 47th street and J.C. Nichols Parkway.[34][35]

Media endorsements

Main article: Endorsements of Missouri ballot measures, 2010

Opposition

  • The Kansas City Star was opposed to the proposed measure. In an editorial, the editorial board said, "Supporters are calling Proposition C on the Missouri statewide ballot the 'Health Care Freedom Act.' It more accurately could be called the 'Futile Gesture Act.' Or perhaps the 'Full Employment for Lawyers Act.' The ballot measure is an empty protest of federal health care reform, instigated by an advocacy group amply funded by health insurers and drug companies. Besides its expense in printed ballots, the measure could end up costing taxpayers plenty in legal fees. Missouri voters should say 'no' on Aug. 3."[36]
  • The St. Louis Business Journal was opposed to Proposition C. In an editorial, the board said, "This measure pits some of the largest corporations and their leadership against the largest health-care institutions (which, not so ironically, are themselves large employers) and their leadership. The corporate leaders and the political leaders who share their sentiments see requiring health-care insurance as infringing on individual freedom. The health-care leaders point to car insurance as an example of a government mandate requiring individuals to submit to the rule of the sovereign...We hope you’ll vote against Prop C."[37]
  • The St. Louis Post-Dispatch was opposed to the proposed measure. In an editorial, they said, "Proposition C is nothing but a taxpayer-funded political exercise designed to raise cash for Republican candidates, consultants and causes. No wonder they call it Prop C...they should reject the August charade and Vote No on Proposition C."[38]

Lawsuit

See also: 2010 post-certification removal litigation

A lawsuit was filed in late June 2010 in the Cole County Circuit Court in an attempt to block Proposition C from appearing on the ballot. According to reports the lawsuit argues that the proposed measure violates the Missouri Constitution because of the way - as a legislatively-referred constitutional amendment - in which it was certified for the ballot.[39] Specifically plaintiffs cite a constitutional prohibition against bills containing multiple subjects. Originally the measure addressed procedures for "insurance companies to voluntarily dissolve. It was amended to include a section stating that people cannot be compelled to have health insurance or penalized for paying their health bills with their own money."[40]

In reaction to the lawsuit Sen. Jim Lembke said, "...a few liberals in this state that want to settle things...in the courts, instead of allowing the people of Missouri to vote on this issue." Sen. Jane Cunningham said that the lawsuit is being pursued because opponents "know they can't win at the ballot box." However, Charles Gentry, the attorney who filed the suit argues that the suit is not about preventing voters from having a say on the measure but to protect "the referendum and ballot process."[41]

The case was heard July 13, 2010.[42]

Arguments

At the July 13 hearing, attorney Chip Gentry argued that the proposed measure includes multiple subjects, violating the single subject rule. "The fact that we have two questions and one box forces Missouri voters into a conundrum' and underscores the fact that lawmakers used 'logrolling' to combine multiple subjects into one bill," said Gentry. State Solicitor Jim Layton, on the other hand, said that both parts of the legislation are focused on the topic of insurance. Additionally Layton noted that voters have in the past voted on measures with several components. Specifically Layton referred to Amendment 2 in 2006 which defined and outlawed human cloning. Additionally, the measure prohibited the Missouri Legislature from denying funding to entities that performed human embryonic stem cell research.[43][44]

The case was heard by Cole County Circuit Judge Paul Wilson. Wilson did not issue a ruling on July 13 but said he planned to issue one as quickly as possible. According to reports Wilson wanted to allow time for appeals and a Missouri Supreme Court decision.[43][45]

Ruling: measure upheld

On Friday, July 16, Cole County Circuit Court Judge Paul Wilson dismissed the lawsuit against Proposition C.[46] In his decision, Judge Wilson wrote that despite arguments that the measure's title was too broad, the Missouri Supreme Court had previously upheld bills that had broader titles. Additionally, Wilson noted that both parts of the proposed measure relate to insurance and thus comply with the single subject rule. The changes made to the text, he noted, remain in line with the bill's original purpose.[47][48]

In his decision Judge Wilson criticized the timing of the suit. He noted that the plaintiffs had more than sufficient opportunities to file a complaint prior to the lawsuit filing.[49]

No appeal sought

In reaction to the July 16 court ruling, Jefferson City Attorney Chip Gentry announced that the plaintiffs did not plan to further pursue the case. "We thought about it and have decided not to appeal at this time; in light of the fact that ultimately what this case was about was to avoid voter confusion and the impossible choice of having two questions in one box. Even if we were successful on appeal, which we feel we would be; the ultimate remedy of actually removing that confusing language from the ballot wouldn’t happen and that the ballots simply would not be counted and would not be certified," said Gentry. In addition to bad timing, Gentry said the plaintiffs did not want to cost the state more money. Absentee ballots had already been cast and ballots had already been printed.[50][51]

Despite the plaintiffs' decision not to appeal the judge's ruling, a challenge following the August election, should the measure be approved, is not out of the question.[50]

Polls

See also: Polls, 2010 ballot measures
  • In a July 19-21, 2010 poll conducted by Mason-Dixon Polling & Research and commissioned by Post-Dispatch/KMOV-TV (Channel 4) a total of 300 likely Democratic primary voters and 300 likely Republican primary voters were polled on Proposition C. According to the results, 67% of Republicans said they planned to vote yes, 16% said no and 17% said they remained undecided. Of the 300 Democrats polled, 27% said yes, 48% said no and 25% said they were undecided. The margin of error is reported to be 6 percentage points. Additionally, according to reports, 61% of the total number of registered voters polled said they were opposed to the health care law passed by Congress in March 2010.[52]


Date of Poll Pollster In favor (Repub.) Opposed (Repub.) Undecided (Repub.) In favor (Dem.) Opposed (Dem.) Undecided (Dem.)
July 19-21, 2010 Mason-Dixon Polling 67% 16% 17% 27% 48% 25%

Path to the ballot

See also: Missouri legislatively-referred state statutes
  • On May 11 the House gave final approval to refer the measure to the ballot following a 108-47 vote.[6]

Similar measures in other states

Groups in Indiana, New Mexico, North Dakota and Wyoming are considering a similar proposal. Two of these states (North Dakota and Wyoming) allow ballot initiatives; in the other three states, the state legislature would have to vote it onto the ballot using their state's procedure for constitutional amendments.[59]

The "Health Care Freedom" or "Health Care Choice" legislation introduced in many states since the passage of the Affordable Care Act are based on model legislation and campaigns from the American Legislative Exchange Council (ALEC). This think tank, promotes "limited government, free markets and federalism." In 2008, prior to the passage of health reform, ALEC adopted the model legislation which is mirrored by several state measures, including Missouri's August measure.[60]

National lawsuit

On July 7 Lt. Gov. Peter Kinder filed a lawsuit against the federal health care bill. Kinder initially announced his intent to file a lawsuit in May 2010. According to reports, the lawsuit asserts that the federal government cannot compel people to buy a product and cannot require state officials to participate in enforcing a "federal scheme."[61] The lawsuit was filed by Kinder and three other Missouri residents - Samantha Hill, Dale Morris and Julie Keathley. The suit was filed in U.S. District Court in Cape Girardeau. Kinder is reportedly raising private money for the lawsuit.[62][63]

With United States President Barack Obama signing the newly passed federal health care bill into law, many states began preparing themselves to combat the health care mandates that are on the verge of taking place across the country. Some states have pending initiatives or legislative referrals for the statewide ballots, however, in other states attorney generals are joining in a national lawsuit.[64][65]

See also

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References

  1. KOMU,"Missouri Takes Step To Block National Health Care Plan," March 4, 2010
  2. Associated Press,"Missouri House seeks to block health insurance mandate," March 3, 2010
  3. The Columbia Daily Tribune,"Missouri legislators OK referendum on health care," May 12, 2010
  4. New York Times,"Health Care Overhaul and Mandatory Coverage Stir States’ Rights Claims," September 28, 2009
  5. Missourinet,"Senate approves healthcare mandate referendum," May 4, 2010
  6. 6.0 6.1 Associated Press,"Mo. to vote in August on health insurance mandate," May 11, 2010
  7. The State Column,"Missouri Voters to Decide Fate of Health Care," May 12, 2010
  8. The Seattle Post-Intelligencer,"Mo. to vote in August on health insurance mandate," May 11, 2010
  9. Kansas City Star,"Missourians to vote on Proposition C, which relates to purchase of health insurance," July 27, 2010
  10. 10.0 10.1 New York Times, "Missouri to Vote on Health Law", July 31, 2010
  11. Missouri Secretary of State,"2010 ballot," retrieved June 10, 2010
  12. Kansas City Star,"Committee to support health care repeal referendum formed," May 21, 2010
  13. Missourians for Health Care Freedom,"Main page," retrieved July 14, 2010
  14. 14.0 14.1 Associated Press,"Mo. Senate Considers Rejecting Health Care Mandate," March 25, 2010
  15. Citizens Commission on Human Rights of St. Louis blog,"Vote for Missouri Proposition C," July 25, 2010
  16. Southeast Missourian,"PRO: Prop C would send a strong message," July 25, 2010
  17. Kansas City Star,"Vote ‘yes’ on Proposition C," July 27, 2010
  18. Bolivar Herald-Free Press,"Prop. C will protect Missourians’ health care choices, lawmaker says," July 28, 2010
  19. Associated Press,"Backers of Missouri measure defying federal health care law raise $23,000," July 16, 2010
  20. 20.0 20.1 Missouri Ethics Commission,"Missourians for Health Care Freedom finance report," July 15, 2010
  21. Missouri Ethics Commission,"Missourians for Health Care Freedom - finance report of contributions of more than $5,000 (1)," July 19, 2010
  22. Missouri Ethics Commission,"Missourians for Health Care Freedom - finance report of contributions of more than $5,000 (2)," July 19, 2010
  23. 23.0 23.1 Associated Press,"Radio ads begin for Missouri measure opposing federal health care reform," July 26, 2010
  24. Missourians for Health Care Freedom,"July 28 fundraiser," retrieved July 28, 2010
  25. Missourians for Health Care Freedom,"Main Page - Into the Final Stretch!," retrieved July 28, 2010
  26. Missouri Jobs with Justice,"August 3 Primary Election, Vote No on Prop C," retrieved July 26, 2010
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  28. Southeast Missourian,"Learn More About Prop C Before You Vote," July 26, 2010
  29. Columbia Daily Tribune,"‘No’ vote would let Missourians tackle real issues," July 27, 2010
  30. Missouri Ethics Commission,"Non-committee Expenditure Report - Missouri Hospital Association," July 21, 2010
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  40. Jefferson City News-Tribune,"Lawsuit challenges Missouri referendum on national health care law," June 23, 2010
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  62. Associated Press,"Mo. lt. gov. sues to block federal health care law," July 8, 2010
  63. St. Louis Post-Dispatch,"Peter Kinder files lawsuit challenging U.S. health-care law," July 8, 2010
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