KHN Morning Briefing

Summaries of health policy coverage from major news organizations

Search For Meaning In Missouri’s Rejection Of Health Law Provision

Republicans are holding up a Missouri ballot measure, which voters approved with 71% support, to reject a key health overhaul provision as evidence that the public does not like the law, The Washington Post reports. "Supporters of the overhaul played down the vote, noting that it has no practical impact and that Tuesday's electorate was largely Republican. But they conceded that a lack of public support could make it hard to put the law into practice." Missouri primary voters were the first to weigh in on the law in a popular vote, but other states, including Virginia, have passed laws seeking to block its implementation (MacGillis, 8/5). 

The Associated Press: "Even if the vote sets no legally binding precedent, it will help mobilize foes of Obama's agenda in the fall midterm elections, and that could make a difference in some states with close congressional races that could decide the balance of power in Washington." The voters specifically rejected federal laws "requiring people to carry health insurance, and penalizing those who don't. That approach is at the heart of the federal health care law that Obama signed in March. Starting in 2014, Americans would be required to carry coverage, with exceptions for financial hardship" (Alonso-Zaldivar and Lieb, 8/4).

Even so, the "Missouri vote is largely symbolic," The Wall Street Journal reports. "If federal courts uphold the health-care law, it would take precedence over any state law that contradicts it. If federal courts throw out the mandate, there would be no need for states to challenge it." A total of 26 states have said they will not challenge the law, supporters of the overhaul say. But, "[w]ith Missouri's move, six states now have laws on the books opposing the federal law. The others-in Idaho, Utah, Virginia, Georgia and Louisiana-were approved by state legislatures" (Fields, 8/5).

The Christian Science Monitor: Other similar referendums will follow in Arizona and Oklahoma. But, "[a] greater threat to the health reform law comes in the form of lawsuits that challenge its constitutionality. Earlier this week, a federal judge in Virginia allowed one of these lawsuits to go forward, challenging the individual mandate. Another lawsuit, filed in a Florida court, argues that the law requires states to expand Medicaid rolls without covering the added costs. Another threat could come indirectly through the ballot box, if voters oust enough Democratic incumbents to shift the balance of power in Congress" (Trumbull, 8/4).

Meanwhile, The Washington Times reports, "some political analysts say that the Missouri measure's decisive margin of victory was impressive despite the high Republican turnout and indicates strong grass-roots distrust of the health care law." The libertarian Cato Institute's Michael Tanner said, "The polls all show that this bill has not gotten any more popular with age. This is still pretty much a mess." Tanner estimates that as many as 40,000 Democrats supported the measure, known as Proposition C, opposing the individual mandate (Lengell, 8/4).

But, "White House press secretary Robert Gibbs flatly dismissed Missouri's vote Tuesday rejecting a key part of the healthcare law," The Hill reports. "Gibbs said Missouri's vote approving a ballot initiative to exempt residents from the new law requiring individuals to buy health insurance was 'of no legal significance.'" Asked about the meaning of the vote, Gibbs replied, "Nothing" (Youngman, 8/4).

The Wall Street Journal: Senate Majority Leader Harry Reid also responded to Republican claims that the vote represents "a rebuke to the sweeping new health law by saying voters like the legislation better the more they know more about it" (Bendavid, 8/4).

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