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Saturday, April 19, 2014

35 states propose ways to prevent health insurance mandate

Eagle staff and news services

Although President Obama's push for a health care overhaul has stalled, conservative lawmakers in more than two-thirds of the states — including Kansas — 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.

Tuesday, Kansas lawmakers introduced resolutions that would allow Kansas voters to add the amendment to the state constitution. The resolutions first must pass the state Senate and House by a two-thirds majority.

Rep. Brenda Landwehr, R-Wichita, and chairwoman of the House Health and Human Services Committee, said government control would mean people have less ability to make health care choices for themselves or their family.

"We do not believe that government has that role," she said at a news conference. "It is important we preserve and protect the rights of the individual to make their own decisions in their health care choices — specifically in their right to pay directly for their health care services."

The Kansas State NAACP issued a statement saying it strenuously opposed the proposed amendment.

"At a time when more than 300,000 Kansans are without health insurance, this amendment, which seeks to obstruct necessary reform measures and protects the practice of insurance companies discriminating against consumers, is wrong for our state and our nation," it said.

Began as backlash

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. The legal impact of state measures may be questionable because courts generally have held that federal laws trump those in states.

Lawmakers in 35 states 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.

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 grassroots 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."

Proposed penalty

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, thus offsetting the increased costs of insuring those with pre-existing conditions or other risks.

The federal bills also would require many businesses to pay a penalty if they fail to provide employee 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 lawmakers have not.

Congressman Todd Tiahrt, R-Goddard, appearing at the Kansas news conference on Tuesday, said he thought it was unconstitutional that the government require people to buy health insurance. He is running for U.S. Senate against Congressman Jerry Moran, R-Hays.

Tiahrt said he thought the issue would end up in court and thought Kansas' amendment could be a test case.

Poll: Put on brakes

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, called the "Freedom of Choice in Health Care Act" in many states. 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, D-Boise. "And the federal government is trying to do something. It hurts our companies and it hurts our people to be uninsured."

Contributing: Associated Press, Jeannine Koranda of The Eagle

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