Wednesday, September 12, 2012

Roundup of 2012 Health Care Reform State Ballot Initiatives

Five states have approved ballot initiatives for the upcoming November election in response to the Affordable Care Act (ACA). In Alabama, Florida, and Wyoming voters will be asked to vote on proposed amendments to their state constitutions. Missouri and Montana voters will also decide questions on the federal law’s reach within their states.

In Alabama, Montana, Wyoming and Florida, the initiatives use similar language seeking to prohibit individuals and employers from being compelled to participate in any health care system or purchase health insurance coverage. This is the Florida legislature’s second attempt at bringing such a question to a vote. In 2010, a similar measure was removed from the ballot when the state Supreme Court held that the measure was misleading and could confuse votes. The offending language is not included in the version that appears on this year’s ballot.

Missouri has framed the issue differently than other states. Voters there will be asked to approve an initiative that focuses on the health insurance exchanges that the states are required to set up under the ACA. If approved, Missouri would be barred from creating a health insurance exchange without prior approval from voters or the state legislature. The state would also be barred from accepting federal funds to use in establishing an exchange.

The outcome of the vote may well be affected by an August 28th ruling by Missouri Judge Dan Green. Judge Green held that the original ballot language drafted by Democrats was not “fair or sufficient.”  The original version asked voters, “[s]hall Missouri law be amended to deny individuals, families, and small businesses the ability to access affordable health care plans through a state based health benefit exchange unless authorized by statute, initiative or referendum or through an exchange operated by the federal government as required by the federal health care act?”  Instead, the judge accepted the Republican-drafted summary.The ballot question will now read, “[s]hall the Missouri law be amended to prohibit the Governor or any state agency from establishing or operating state based health insurance exchanges unless authorized by a vote of the people or by the Legislature?”


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