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Posted on Thu, May. 20, 2010 10:15 PM
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Health care ballot issue displays Missouri’s folly

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If summer vacation plans don’t have you excited this year, here’s a cheery prospect for Missourians: We get to liven up those dog days of August with a statewide vote on health care reform.

How we vote isn’t likely to have much effect beyond setting off a prolonged legal ruckus at taxpayers’ expense. But think of the grandstanding possibilities!

With primary elections scheduled for the same day, Aug. 3, politicians will be knocking themselves out to stand with the people of Missouri against the big, bad federal government and its attempt to guarantee that most Americans have access to health care.

A number of states have passed laws or constitutional amendments that basically stick a thumb in the eye of Congress, President Obama and the Affordable Health Care Act.

All use similar language, which was prepared by the American Legislative Exchange Council, a business advocacy group amply funded by health insurers and drug companies.

“It’s a very powerful organization,” said Missouri Sen. Jane Cunningham, a Republican from Chesterfield who pushed relentlessly for the state to join the opt-out movement. She sits on the council’s board of directors.

Several states are putting the issue to voters in November. Missouri will have the distinction of going first in August. Hey, who needs a competitive baseball team when you’ve got a groundbreaking ballot issue?

We’ll be voting on whether to “deny the government authority to penalize citizens for refusing to purchase private health insurance or infringe upon the right to offer or accept direct payment for lawful health care services.”

(In one of those bizarre muddles that often emerge from the Missouri legislature, the ballot language also goes on to ask whether the state should “modify laws regarding the liquidation of certain domestic insurance companies.” The two seemingly unrelated items are a package. They will rise or fall together.)

The “health care freedom act,” as supporters are calling it, is an intentionally vague statement, but it clearly takes aim at the requirement in the health care reform act that everyone who can afford health insurance must purchase at least a bare-bones policy or pay a small fine.

The individual mandate, as it is called, is not some new, socialist idea. Republicans have proposed it as a free-market solution for 30 years. The concept is that if you want to stop insurers from denying affordable coverage to sick people who use a lot of services, you have to get the healthy people who use minimal services into the pool. Otherwise, insurance will become unaffordable for everyone.

In a way, the animosity toward the mandate is puzzling. It’s true that Americans don’t appreciate the government telling them they have to do something. But nor do we generally approve of free riders, those folks who use services like hospital emergency rooms and expect somebody else to pick up the tab.

In a better political climate, the notion of sharing health insurance risks would be seen as an act of citizenship, not government oppression.

But here we are, and the revolt is on.

Fortunately, Missouri Attorney General Chris Koster is declining to join the attorneys general who are suing to overturn the health care reform law, although Lieutenant Gov. Peter Kinder has been blustering about taking matters into his own hands.

Most legal experts think the health care reform act, including the individual mandate, is on solid constitutional grounds. They give low odds to the lawsuits succeeding and even dimmer chances for opt-out measures like the one proposed in Missouri.

“The notion that a state can just choose to opt out is just preposterous,” Harvard Law School professor and former Reagan administration solicitor general Charles Fried told National Public Radio. “One is left speechless by the absurdity of it.”

But political theater often shares the stage with the theater of the absurd.

In Missouri, the curtain is about to rise.

To reach Editorial Board member Barbara Shelly, call 816-234-4594 or send e-mail to bshelly@kcstar.com. She blogs at voices.kansascity.com.

Posted on Thu, May. 20, 2010 10:15 PM
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