Health-Care Balloting in Missouri: Voters Say No to Insurance Mandate

Under the mundane title "Proposition C," Missouri voters on Tuesday tried to opt out of the new federal requirement for most Americans to have health insurance, voting overwhelmingly to reject the individual mandate in the health law.

"The citizens of the Show Me State don't want Washington involved in their health care decisions," State Sen. Jane Cunningham, a Republican sponsor of the ballot issue, told the St. Louis Post Dispatch. "I've never seen anything like it. Citizens wanted their voices to be heard."

The practical effect of the near 3-1 vote for the measure is unclear. The insurance mandate does not even take effect until 2014, and efforts by states to nullify parts of the federal health law are certain to wind up in court -- where judges tend to side with the federal government under the Constitution's supremacy clause.

Even if it is symbolic, Missouri does stand out as the first state to successfully challenge the new health law on the ballot. And the strong vote in the bellwether Midwestern state could hearten opponents of President Obama's legislative triumph in Arizona, Oklahoma and Florida, where votes on similar issues are set for November.

"It's like a domino, and Missouri is the first one to fall," Cunningham asserted.

In Missouri, however, the ballot issue did not command heavy attention among the public, The New York Times said. The vote to nullify the insurance mandate was driven primarily by the Republican primary electorate, who turned out for competitive races among GOP candidates as well as for the ballot issue, according to the newspaper.