Missouri's Proposition C Vote: 'Health Care Freedom Act' Set to Test Obamacare

For those of you who have still been watching the debate over the health care reform law: something's happening next month that could take it to a whole new level.

On August 3, the voters of the state of Missouri will go to the polls to cast a ballot on Proposition C, also known as the "Health Care Freedom Act." The measure has passed in the Missouri House and Senate, and it is now going straight to the people. If approved by the voters, the act would amend state statutes to effectively shield Missourians from complying with the federal health reform law, protecting them from fines and penalties, and would "prohibit any person, employer, or health care provider from being compelled to participate in any health care system."

It has been nearly four months since President Obama and Democrats passed their landmark health care reform bill after weeks of intense debate. The debate has since simmered, but questions remain about the bill's future. In April, the Center for Medicare and Medicaid Services reported that the bill would increase health care spending. All spring and summer, more attention has been paid to the fact that Massachusetts's similar 2006 health care law is creating significant coverage, cost, and other issues in the the state. On July 5, Rasmussen Reports found that 60 percent of Americans favor repeal of the law. And on July 7, Republican Senators (and doctors) Tom Coburn (R-OK) and John Barasso (R-WY) released a highly-critical oversight report on Obamacare's first 100 days.

After months of rallies and protests for and against the bill, the American people have not yet had a single chance to actually cast a vote on Obamacare. August 3 will be the first time anywhere in the country that voters will be able to make their voices heard in a clear-cut fashion. As one blogger from Red State opposed to Obamacare phrased it: "We've been forced to speak through rallies and a diminished Republican party, until now. Now there is an opportunity for the average voter to act upon that disgust."

If the Health Care Freedom Act passes in Missouri, especially by a large margin, the "repeal Obamacare" armada will be recharged. The Tea Party, conservative Republican candidates, and a plethora of advocacy groups will trumpet (and no doubt exaggerate) a huge victory against Obama's big-government agenda. The victory, of course, will be a mostly symbolic one, as courts usually rule that federal law trumps state law. In many ways what happens in Missouri may only be a small skirmish in the larger war to repeal Obamacare. However, a victory will provide a much needed morale boost to those who have been fighting for repeal since the day the legislation passed.

Consider that attorney generals in twenty states (all Republicans) have filed lawsuits against the federal government, setting up an interesting White House fight in the Roberts Supreme Court. Activists in other states are also working on launching repeal efforts, at least in states where repeal is favored; meanwhile, the Republicans in Congress have relaunched their repeal push. A win in Missouri would be proof that support for repeal -- at least on a state level -- is politically sustainable nearly half a year after passage, and would spur conservative activists in other states to increase their efforts.

With Democrats' attention focused on the struggling economy, high unemployment, trouble in Afghanistan, the Gulf oil spill disaster, and the looming deficit, a win in Missouri is the last thing national Democrats need right now. Yet, if the proposition passes, they will have to address it as angry voters get again question their elected officials.

Proposition C's passage could even have some implications for Obama's re-election campaign in 2012. In 2008, Missouri bucked a near century-long trend of always voting for the presidential winner when John McCain won the state by a mere 4,000 votes. Missouri is considered a fine cross-section of the United States electorate, and a challenge to Obama's signature legislative accomplishment there could tell the White House that it will not play well elsewhere come 2012. Obama has made several trips to Missouri since his inauguration; if Missouri has abandoned him, the odds that states he won by 1-4 percent in 2008 (Florida, Indiana, North Carolina, Ohio) will turn their votes are significantly higher.

But what if the Health Care Freedom Act fails this August?

Just as a win in Missouri would be of huge promise for those who oppose Obamacare, a loss would be potentially devastating for the movement. The liberal blogosphere and activists on the ground would be filled with hope that, perhaps, Obamacare won't prove as potent a political weapon as Republicans hope. It would be one thing if this loss occurred in a blue state. But if an anti-health care reform measure can't even pass in a state that voted for John McCain, where 53 percent disapprove of Obama and 61 percent favor repeal of health care reform, what hope would such measures have elsewhere?

Now that the law is officially enacted and on the books, repealing it is extremely complicated, requiring intense and persistent pressure (it can be done, though, as evidenced by the ultimate repeal of the 1988 Medicare Catastrophic Coverage Act). Such a defeat in Missouri, however, could harshly mitigate that pressure. The legal battles are another matter, but if politics is all about momentum, the advantage would certainly rest with Obamacare.

A loss could also deal a devastating blow to the Tea Party. The movement's original fuel, back in the summer of 2009, was town halls full of voters angered over health care reform. While the movement now has become more comprehensive and addresses other issues, anger over the bureaucratic over-reach of health care reform and the backroom brokering to pass it (the Cornhusker Kickback and the Louisiana "Purchase") is still the driving issue for many Tea Partiers.

True to form, the "Show Me" state will soon indicate just how popular (or unpopular) Obama's health care reforms are, and how resilient they can be in the face of political pressure. Perhaps even more fitting, however, is the state's official motto: Salus Populi Suprema Lex Esto. "Let the welfare of the people be the Supreme Law." Next month, Missourians will judge whether they want Obamacare to be a part of the law.