By Sam Baker and Elise Viebeck - 11/05/12 07:24 PM EST
President Obama’s healthcare law isn’t just a big issue in the 2012 presidential campaign — it’s on the ballot directly in a handful of key states.
Republican candidates have worked hard to make “ObamaCare” a central issue in their push to unseat the president as well as several Democratic senators. In some states where attacks on the law have been strongest, voters will have a chance to weigh in on healthcare apart from those races.
Swing-state Florida is one of four states where voters will be asked to formally register their disapproval of the Affordable Care Act’s least popular provision — the mandate requiring most taxpayers to buy insurance or pay a tax penalty.
Florida’s ballot measure would change the state constitution to stipulate that “a law or rule may not compel, directly or indirectly, any person or employer to purchase, obtain, or otherwise provide for health care coverage.”
Just to be safe, Florida’s proposed amendment also specifies that “the private market for health care coverage of any lawful health care service may not be abolished.”
Anti-mandate measures are also on the ballot in Alabama, Wyoming and Montana — home to a pivotal Senate race between Democratic Sen. Jon Tester and Republican Rep. Denny Rehberg. The most recent polls show Rehberg ahead.
The most substantive healthcare ballot measure comes in another state with a high-profile Senate race: Missouri. Voters there will decide on a proposal that would bar the governor from creating an insurance exchange without approval from the state legislature or another ballot initiative.
Exchanges are perhaps the most important piece of the healthcare law. They’ll function as one-stop shops where individuals and small businesses can compare and purchase health plans, often with financial help from the federal government. The law envisions each state setting up its own exchange but authorizes a federally run fallback in states that don’t act.
Sixteen states have moved forward on their own exchanges, according to the Kaiser Family Foundation. And while most have done so with legislation, three governors have used executive orders to bypass their legislatures. Missouri’s ballot measure would prohibit the use of an executive order — and, given the makeup of the statehouse, probably ensure a federally run exchange.
Anti-healthcare measures could theoretically help rally the GOP base, but “ObamaCare” is already a central theme of the Senate races in Florida, Montana and Missouri. The Democratic incumbents in all three states — Bill Nelson, Tester and Claire McCaskill, respectively — all voted for the healthcare law.
Furthermore, an anti-mandate measure passed last year in Ohio in a special election with especially strong Democratic turnout.
Abortion, another issue that roiled the presidential race, will make only a few appearances on state ballots.
In Montana, one measure would require parental notification prior to a minor obtaining an abortion. And in Florida, Amendment 6 echoes the position of Republicans in Congress — limiting abortion rights and barring public funds from supporting the procedures.
Federal law includes this prohibition, and the Florida measure seeks to impose it at the state level. On a practical level, the initiative would prevent state employees from using their healthcare coverage for abortions except in cases of rape, incest or when the woman's life is threatened.
Amendment 6 would also make privacy rights in Florida no more expansive that they are federally, a development that will pave the way for further abortion restrictions in the state. Supporters of Amendment 6 have said their final goal is a law that requires parental consent for young women's abortions, now impossible because of a 1989 Florida Supreme Court ruling the new initiative would void.