Midterm voters in three states will cast ballots on healthcare insurance mandate

Arizona and Oklahoma are expected to pass the state constitutional amendment, but it faces an uphill battle in Colorado. 

The measure on the ballot in Arizona and Oklahoma is modeled after legislation drafted by the conservative American Legislative Exchange Council. It says the states' citizens can't be forced to participate in a public or private health plan, can choose to pay a doctor directly for medical services and can't be forced to pay a fine for not having insurance.

More than 70 percent of voters in Missouri's Aug. 3 open primary voted to adopt a similar measure. The Missouri vote was on accepting a state statute and not a state constitutional amendment.

Legal experts say the measures are just for show because states can't ignore federal law. But proponents say they send a clear message to politicians and give the states standing in challenging the new law in federal court.

The legislation first surfaced after Massachusetts in 2006 adopted its health reform law, which also has an individual mandate. The measure at the time was aimed at state lawmakers who were considering similar legislation.

Since then, passage of federal health reform has inflamed opposition to the mandate, without which insurers say they can't afford to provide all the coverage improvements required by the new law. Legislatures in at least six states — Virginia, Idaho, Arizona, Georgia, Missouri and Louisiana — have already passed statutory measures rejecting the individual mandate.

The constitutional amendment was on the Arizona ballot and barely failed in 2008. It was on the ballot in Florida this year but a circuit court judge knocked it off, calling its wording "manifestly misleading" because its summary language appears to guarantee that patients would never again have to wait in a doctor's office if it was passed. 

In Colorado, the citizen initiative is written more broadly and prohibits "the state independently or at the instance of the United States from adopting or enforcing any statute, regulation, resolution, or policy that requires a person to participate in a public or private health insurance or coverage plan." Opponents say the Colorado initiative is too broad and could have unforeseen effects on Medicaid and other public programs.

Here's how the measure polls:

  • In Arizona, Proposition 106 had the support of 38 percent of respondents in a mid-October Rocky Mountain News poll. Those opposed and the undecided polled at 31 percent each;
  • Colorado's Amendment 63 fared much worse, according to a 9 News/Denver Post poll from mid-October: 24 percent of respondents were in favor, versus 36 percent opposed and 40 percent undecided. The measure is the only one of five citizen-generated measures that's not rejected by a majority of those polled;
  • Meanwhile, Oklahoma's State Question 756 is almost sure to pass, garnering the support of 66 percent of respondents in a Tulsa World poll last week (only 23 percent were opposed, and 11 percent were undecided).