States Try To Override Federal Health Care Mandate

As the health care debate continues in Washington, some states are taking steps to limit or block changes. In Arizona, voters are being asked to ratify a legislative move that gives residents the right to opt-out of any health-care system.

Copyright © 2009 NPR. For personal, noncommercial use only. See Terms of Use. For other uses, prior permission required.

STEVE INSKEEP, host:

Now, Congress is still working on the health care overhaul, and it could require everyone to get health insurance, a mandate that you get health insurance. A dozen states are working on laws that would allow people to opt out of that mandate if they wanted to. It is not clear whether such state laws could override a federal mandate. NPR's Ted Robbins reports from the state where the movement started.

TED ROBBINS: It actually began three years ago, when Eric Novak walked into Clint Bolick's office in Phoenix. Novak is an orthopedic surgeon in Arizona who wanted to stop government, state or federal, from making a person or an employer have health care coverage. Bolick is a lawyer at the Goldwater Institute, a conservative think tank. Together, they proposed an amendment to Arizona's constitution labeled the Freedom of Choice in Health Care Act. Clint Bolick says it was ahead of its time.

Mr. CLINT BOLICK (Attorney, Goldwater Institute): Because when this idea first was presented to the Arizona voters, really, it did not resonate.

ROBBINS: Voters narrowly defeated the ballot proposal last year.

Mr. BOLICK: But man, things have changed in just a few months.

ROBBINS: The national health care debate is on now, and Arizona's legislature has voted to put virtually the same amendment on next year's ballot. It would essentially do three things: Allow employers to opt out of providing health insurance without a fine or a penalty, allow individuals to opt out of a health insurance mandate, and guarantee that people could buy their own health care directly, without any third party.

Mr. BOLICK: It seems to us that once you force someone to belong to a medical system, it's bad from an economic standpoint, and it's also bad from the control that we ought to have over our own health care freedom.

ROBBINS: The idea that health people would have to pay into a government system to support the sick the way working people pay into social security to support the retired or disabled is anathema to Bolick and to Tom Emmer. Emmer is a Republican state representative in Minnesota. He heard about the Arizona idea and introduced an almost identical bill in Minnesota, where I reached him on his cell phone.

State Representative TOM EMMER (Republican, Minnesota): What it says is no one can be forced against his or her will to participate in a government health care program, because it will ultimately destroy the private health insurance option.

ROBBINS: Emmer, who is running for governor, worries a government-sponsored public option would hurt the free market. Emmer wants to expand private insurance through high-risk pools or state insurance exchanges.

ROBBINS: Daniel Patterson is a Democratic representative back in Arizona. He doesn't understand why these bills are necessary now.

Representative DANIEL PATTERSON (Democrat, Arizona): All we're seeing is a paranoid, knee-jerk reaction before Congress has even taken any action.

ROBBINS: Patterson notes that every proposal before Congress allows people to keep their current health insurance if they like it. He says the time has come for everyone to have health insurance, which won't happen without a federal mandate.

Rep. PATTERSON: I think it's just people have a fundamental right to basic level of health care. We're a great nation. We're a powerful nation. That's one of the areas where we're probably the weakest is our health care system. We need to extend that to all people.

ROBBINS: Although, even Patterson says he has reservations about mandatory health care coverage, unless the government has a way to pay for those who can't afford it.

If it passes, any state ban on a federal mandate will likely end up in court, which is OK with the Goldwater Institute's Clint Bolick. No Supreme Court in memory, he says, has been more sympathetic to state sovereignty than the current court.

Ted Robbins, NPR News, Tuscan.

Copyright © 2009 NPR. All rights reserved. No quotes from the materials contained herein may be used in any media without attribution to NPR. This transcript is provided for personal, noncommercial use only, pursuant to our Terms of Use. Any other use requires NPR's prior permission. Visit our permissions page for further information.

NPR transcripts are created on a rush deadline by a contractor for NPR, and accuracy and availability may vary. This text may not be in its final form and may be updated or revised in the future. Please be aware that the authoritative record of NPR's programming is the audio.

Comments

 

Please keep your community civil. All comments must follow the NPR.org Community rules and terms of use, and will be moderated prior to posting. NPR reserves the right to use the comments we receive, in whole or in part, and to use the commenter's name and location, in any medium. See also the Terms of Use, Privacy Policy and Community FAQ.