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Proposition C landslide sends strong message, proponents say

In a political showdown that Republicans favored and Democrats wanted to avoid, Missouri voters gave strong approval to Proposition C, the state referendum that calls for Missouri to opt out of the federal health care reform law that was passed four months ago. More than 72 percent of Missouri voters supported the measure.

The opposing sides were predictably divided over what the outcome meant. Republicans said it exposed widespread opposition to the federal law, the Affordable Care Act, while Democrats argued that the vote focused on a narrow issue with the outcome influenced by a low turnout. 

A jubilant state Sen. Jane Cunningham, R-Chesterfield, said that she was surprised that more than two-third of voters supported the measure, which she sponsored. She said the voter reaction reinforced her argument that states want to have a say about health care policies inside their own borders.

“It was obvious that we were going to win,” she says. “One political analyst had said that if we won by 55 percent, it would send a message to Washington. To win by two-thirds means Missouri has picked up a megaphone to send that message. The message is that we don’t want Washington to take over our health care.”

Noting that the outcome of the election was being closely watched nationally, Cunningham said Missouri has set into motion a “domino effect that will be a strong influence on other states that vote in November.”

Legislatures in Arizona, Georgia, Idaho, Louisiana and Virginia already have approved measures similar to Missouri ’s proposition. In addition, voters in at least two states – Arizona and Oklahoma – will have their say about the law in the November general election. Cunningham adds that the outcome in Missouri also will encourage other states to propose ballot language similar to Missouri’s. She and about 100 other invited guests celebrated the victory of Proposition C at a home in Town and Country.

One key supporter of the measure was Annette Read. She and her sister, Margaret Walker, founded an organization called I Heard the People Say. It has been promoting the proposition, formally known as the Health Care Freedom Act, through email and public events.

Read said “This win is a victory for everything we’ve worked for.” She said her organization was separate from the Tea Party movement, which also supported the measure. She added that her organization was not against health reform but wanted it to happen “one piece at a time” and wanted to “balance the power of the federal government with states rights.”

Democrats had adopted what amounted to a silent treatment strategy, apparently hoping that ignoring the ballot measure would lead to a lower turnout by Republicans and Tea Party members who had been energized by enactment of the health reform legislation.

“While we’re disappointed that Missourians didn’t vote against this, we think the courts will ultimately decide it,” David M. Dillon, a spokesman for the Missouri Hospital Association, told the New York Times.

Amy Smoucha, of Jobs With Justice in Missouri, says opponents of Proposition C already are looking beyond Tuesday’s vote.

“We’re happy this election is passed,” she says. “It was a highly polarized issue with lots of misinformation about the federal law. Some were arguing that the law would lead to a single payer system, which was not true.”

She adds that Missouri voters will like the federal law once its provisions begin taking effect. These, she said, include provisions such as preventive care, protection for people with pre-existing conditions, and protection against arbitrary limits on benefits by insurers.

“We’re keeping this in perspective,” she says of the election. “It was a low voter turnout with a very narrow question on the ballot. It didn’t address all of the issues in the Affordable Care Act.”

Prop C drove turnout

Dave Roland, a policy analyst at the Show-Me Institute, said Proposition C was the big driver in the election. The statewide GOP turnout of 577,612 or 65 percent roughly doubled the turnout of Democrats of 315,787 or 35 percent, he noted.

He added that a significant number of people apparently came to the polls primarily to vote on Prop C. He says the 938,782 votes for the proposition means that 40,000 more votes were recorded for the measure than were cast in the primaries for U.S. senator, where the total vote was 898,784.

“Despite the fact that primary elections are more likely to bring out the dyed-in-the-wool base of each party, large numbers of people voting in the Democratic primaries were voting in favor of Prop C,” Roland said, noting that at least 29 percent of St. Louis city voters who cast a Democratic ballot favored Prop C, as did 20 percent of  Democrats who voted in Kansas City.

If Missouri’s results are echoed in other states, Roland argued that “it could become very difficult for the federal government to enforce the health care mandate -- and it might well force a revision or complete repeal of the health care reform law.”

Roland also called attention to the decision by U.S. District Judge Henry Hudson in Virginia. He denied the Obama administion’s motion to dismiss a lawsuit by the Virginia attorney general challenging the constitutionality of the individual mandate in the federal health reform law.

Roland said the Virginia lawsuit is similar to one filed by Missouri Lt. Gov. Peter Kinder. Roland believes the Kinder lawsuit “is doomed to failure,” and he hadn’t expected the Virginia judge to allow the case to go forward.

“I’d be surprised if other courts follow suit, but perhaps not,” Roland said. “We may get some resolution on the constitutionality of the federal health care law much sooner than I anticipated.”

At the polls

Grant Welland, a bearded retired math professor at the University of Missouri-St. Louis, didn’t seemed bothered by poll predictions when he cast a ballot against Proposition C, the state initiative that turned the nation’s eyes toward Missouri.

He opposed the measure, which says voters in Missouri should not have to follow a federal mandate requiring that most people buy health insurance. Although the measure is expected to win and put Welland on the losing side, he seemed confident that the outcome won’t be as lopsided as many pollsters have predicted.

As he cast his ballot at a polling site in the 200 block of Union Boulevard, Welland said even if the measure passes, it would reinforce his view that Republicans are simply naysayers about everything the Obama administration might propose.

“No new taxes means no new bridges, no new schools, no new health reforms,” he said.

This article originally appeared in the St. Louis Beacon.

Robert Joiner has carved a niche in providing informed reporting about a range of medical issues. He won a Dennis A. Hunt Journalism Award for the Beacon’s "Worlds Apart" series on health-care disparities. His journalism experience includes working at the St. Louis American and the St. Louis Post-Dispatch, where he was a beat reporter, wire editor, editorial writer, columnist, and member of the Washington bureau.