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Sept 29 09 State amendments could limit health overhaul

State amendments could limit health overhaul

By Monica Davey, New York Times  |  September 29, 2009

ST. PAUL – In more than a dozen statehouses across America, a small but growing group of lawmakers has been pressing for state constitutional amendments that would outlaw a crucial element of the health care plans under discussion in Washington: the requirement that nearly everyone buy insurance or pay a penalty.

Approval of the measures, the lawmakers suggest, would set off a legal battle over the rights of states versus the reach of federal power, an issue that is, for some, central to the current health care debate but also one that has tentacles stretching into a broad range of other matters, including education and drug policy.

Opponents of the measures and some constitutional scholars say the proposals are mostly symbolic, intended to send a message of political protest, and have little chance of succeeding in court over the long run. But they acknowledge the measures could create legal collisions that would be costly and cause delays to health care changes and could be a rallying point for opponents in the increasingly tense debate.

“This does head us for a legal showdown,’’ said Christie Herrera, an official at the American Legislative Exchange Council, a group in Washington that advocates limited government and free markets and which earlier this month offered guidance to lawmakers in more than a dozen states during a conference call on the state amendments.

So far, the notion has been presented in Arizona, Florida, Michigan, Minnesota, Ohio, Indiana, North Dakota, New Mexico, West Virginia, and Wyoming, although it has already failed in the latter five. Lawmakers in Georgia, Kansas, Louisiana, and Utah have said they will soon offer similar measures in what has grown into a coordinated effort at resistance.

In Minnesota, as in many of the other states, the move to amend the state constitution is being driven by a handful of Republican lawmakers.

Many who favor a federal overhaul of health care say it can be affordable only if nearly everyone is required to carry insurance, but the efforts by these state lawmakers predate the Obama administration and the current health care debate.

The groundbreaking 2006 law in Massachusetts requires nearly everyone to have health insurance or pay a tax penalty of as much as $912 a year, though there are exemptions for financial hardship.

Proposed constitutional amendments began cropping up after Massachusetts passed its measure. Elsewhere, some leaders, opposed to the possibility of insurance mandates or government-run systems, began suggesting constitutional amendments to block such measures from their states.

In Arizona – with help from Dr. Eric Novack, an orthopedic surgeon who says his intent was not “some grand secessionist plot’’ but a health care overhaul with protections for individuals’ rights – an amendment first went before voters in 2008. The idea lost, but by fewer than 9,000 votes among more than two million cast. This year, Arizona’s Legislature, dominated by Republicans, voted to send the question back to the ballot in 2010.