States seeking to ban mandatory health insurance

Posted February 1, 2010

— Although President Barack Obama's push for a health care overhaul has stalled, conservative lawmakers in about half the states are forging ahead with constitutional amendments to ban government health insurance mandates.

The proposals would assert a state-based right for people to pay medical bills from their own pocketbooks and prohibit penalties against those who refuse to carry health insurance.

In many states, the proposals began as a backlash to Democratic health care plans pending in Congress. But instead of backing away after a Massachusetts election gave Senate Republicans the filibuster power to halt the health care legislation, many state lawmakers are ramping up their efforts with new enthusiasm.

The moves reflect the continued political potency of the issue for conservatives, who have used it extensively for fundraising and attracting new supporters. The legal impact of any state measures may be questionable because courts generally have held that federal laws trump those in states.

Lawmakers in 34 states, including North Carolina, have filed or proposed amendments to their state constitutions or statutes rejecting health insurance mandates, according to the American Legislative Exchange Council, a nonprofit group that promotes limited government that is helping coordinate the efforts. Many of those proposals are targeted for the November ballot, assuring that health care remains a hot topic as hundreds of federal and state lawmakers face re-election.

Legislative committees in Idaho and Virginia endorsed their measures this past week. Supporters held a rally at the Pennsylvania Capitol. And hearings on the proposed constitutional amendments were held in Georgia and Missouri. The Missouri hearing drew overflow crowds the day after Obama urged federal lawmakers during his State of the Union address to keep pressing to pass a health care bill. The Nebraska Legislature plans a hearing on a measure this coming week.

Supporters of the state measures portray them as a way of defending individual rights and state sovereignty, asserting that the federal government has no authority to tell states and their citizens to buy health insurance.

"I think the alarm bell has been rung," said Clint Bolick, the constitutional litigation director at the Goldwater Institute in Phoenix, which helped craft an Arizona amendment on this November's ballot that has been used as a model in other states.

"These amendments are a way to manifest grass roots opposition" to federal health insurance mandates, Bolick said. "They kind of have a life of their own at this point. So while some of the pressure may be off, I think that this movement has legs."

Separate bills passed by the U.S. House and Senate would impose a penalty on people who don't have health insurance except in cases of financial hardship. Subsidies would be provided to low-income and middle-income households. The intent of the mandate is to expand the pool of people who are insured and paying premiums and thus offset the increased costs of insuring those with preexisting conditions or other risks.

The federal bills also would require many businesses to pay a penalty if they fail to provide employees health insurance that meets certain standards, though details and exemptions vary between the House and Senate versions.

Obama and Democratic legislative leaders were working to merge the two bills when Republican Scott Brown won the Massachusetts Senate seat long held by the late Edward M. Kennedy on Jan. 19, leaving Democrats one seat shy of the number needed to break a Republican filibuster.

Since then, the federal legislation has been in limbo. But state lawmakers have not.

"We need to move ahead no matter what kind of maneuvering continues in Washington, D.C.," said Missouri Sen. Jane Cunningham, a Republican from suburban St. Louis.

Since suffering resounding defeats in the 2008 elections, Republicans have seized upon voter unease over the federal health care legislation to help revitalize their fortunes.

A USA Today/Gallup poll conducted the day after the Massachusetts vote found that about 55 percent of respondents - including a majority of self-described independents - favored putting the brakes on the current health care legislation. The poll had a margin of error of plus or minus 4 percentage points.

State laws or constitutional amendments clearly could bar lawmakers in those states from requiring individuals to purchase health insurance, such as Massachusetts has done. But it's questionable that such the measures could shield state residents from a federal health insurance requirement.

"They are merely symbolic gestures," said Michael Dorf, a constitutional law professor at Cornell University. "If this Congress were to pass an individual mandate, and if it is constitutional - which I believe it is - the express rule under the supremacy clause (of the U.S. Constitution) is that the federal law prevails."

Many Democratic lawmakers are skeptical of both the intent and the effect of the state measures, entitled in many states as the "Freedom of Choice in Health Care Act." Some have derided it as "political theater" or an attempt to merely shape the public debate.

"We need to do something about health care," said Idaho Rep. Phylis King, a Boise Democrat. "And the federal government is trying to do something. It hurts our companies and it hurts our people to be uninsured."


Associated Press writer John Miller in Boise, Idaho contributed to this report.


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  • mep Feb 1, 2010

    Tell it like it is Worland!!!!

    Its not the insurance companies that are driving up the cost of healthcare. With only a 3% profit margin, they HAVE to deny coverage to some. It is all about statistics. Insurance is about risk. People need to realize that insurance companies, doctors, nurses, drug manufacturers, medical equipment suppliers... are all in business to make MONEY! It is only the Federal govt that does not mind losing money. But hey, its taxpayers money not theirs so why do they care? A trillion here, a trillion there....

  • blackdog Feb 1, 2010

    If the insurance industry hadn't had to spent so many billions of dollars fighting reform, I would have made more in dividends. Things look better now. If we can abolish non profit insurers, profits can soar. Wellpoint showed non profit, BCBS how to make a profit in the 14 states Wellpoint took BCBS over in.

  • blackdog Feb 1, 2010

    We need to end social welfare and care. Private insurance WITHOUT government subsidies, is free enterprise. Buy stock if you want cheaper insurance. Can't afford any ?....TOUGH !

  • Iconoclast Feb 1, 2010

    Beachboater, I used to work partime for a mom and pop ISP. As a favor to a friend and ex-employee, they give me broad band free. Yeah, I'm lucky and they're very nice people. By the way, my computer was the one big splurge I purchased with an inheritance, the rest was given to support my late in-laws. The computer is now seven years old, but still going strong.

  • beachboater Feb 1, 2010

    Do you know of any poor people that have been turned down medical care at any area hospital? There are not for profit government subsidized health care facilities in most rural areas.

    One key part of health care reform is tort reform. Don't do away with medical malpractice. Just make the loser pay the winner's legal bills. That in itself would stop many frivilous cases that tie up the courts and cost all of us millions of dollars.

  • Worland Feb 1, 2010

    Someone has been reading too many left wings lies... insurance companies average a whopping 3% profit. They're not exactly making huge profits from being super "evil". Let's not forget the Dems have been courting the insurance companies behind closed doors all year offering huge incentives to support socialized medicine.

    The Dems thrive on class warfare. They fail to tell you the real truth. Like oil companies... they make about 9% profit and actually lose money refining gasoline. They make make their billions on volume. Simple math (something they don't seem to teach at Harvard Law). The "rich", who pay 86% of the taxes in this country, are somehow not paying their fair share? Get a clue!

  • beachboater Feb 1, 2010

    "I have only a landline phone, no cell phone at all. I have a thirty year old TV set with a converter box. I got plenty of exercise doing manual labor (before I became disabled from doing heavy manual labor). My eating habits were poor because fatty and starchy foods are cheaper. Wake up. Your stereotypes show the level of your ignorance and prejudice. Most working poor folks have none of the "luxuries" that you would accuse us of."

    Yet, you have fast enough internet access and computer to post about every other response in this thread.

  • EyesintheSkies Feb 1, 2010

    millerB, glad you found it funny. Where would you prefer to go to have a major illness treated? And upon deciding that, why are you still here?
    The country is still free. You can go to greener pastures any time.

  • Iconoclast Feb 1, 2010

    Eyesintheskies, as I said, I doubt the facts will affect you, but just so the record is straight. I voted for Richard Nixon, Jesse Helms, George Bush elder and younger, Elizabeth Dole, etc. Then I got tired of folks who were so self-righteous that they would find any excuse to oppose government help for those who need it. I started volunteering as a teenager and continued till my health made me stop. When I was working 72 hours a week, every week, I still voluteered on average five or six hours a week, many times more. By the way, it depends on which poll you look at as to which side the "majority' of the people are on. And if "the majority" is all that concerns you, then you wouuld have been very happy fifty years ago when "the majority" of the people wanted Jim Crow segregation and thought it was right

  • marty19702003 Feb 1, 2010

    The republicans are doing the best they can to protect the bottomline (billions of dollars in profits) for the insurance companies, including distorting facts and claiming communism and their foot soldiers (useful fools) think they have a movement for the people. newsflash: the only people you are helping are insurance executives---fools! and to the republicans: shame on you for taking the money!