Missourians voted overwhelmingly Tuesday to overturn a core element of President Obama's health-care reform, becoming the first voters in the nation to render a symbolic verdict on the controversial law.
More than 7 voters in 10 on Tuesday supported Proposition C, a ballot measure designed to allow state residents to ignore the federal law's mandate on individuals to either buy health insurance or become insured with government help. With nearly 1 million voters participating, typically light turnout for a primary election day, 29 percent opposed the measure.
Although the ballot measure focused on just one element of the health reform law – the individual mandate – the vote was to some degree a test of public opinion of the law itself. It comes as other states are mounting legal challenges to the law and as both Democrats and Republicans are focusing on health care as a core issue for congressional elections this fall.
Missouri is often a bellwether state in presidential elections. In this case, the margin of support for Proposition C may overstate the level of public opposition to what critics call "Obamacare." But at the least, the vote confirms that the issue could be one that aids and energizes Republicans this fall.
"All throughout the health-care debate, Democrat leaders in Washington told themselves they could do what they want, and then persuade Americans after the fact that it was okay," Senate minority leader Mitch McConnell (R) of Kentucky said in a statement released Wednesday. "Last night, the voters in Missouri overwhelmingly rejected that notion. The people of Missouri have sent a message to Washington: enough is enough."
He said he applauded Missouri voters for rejecting the mandate on individuals, and he interpreted the vote as a broader rejection of bigger government.
Recent opinion polls generally find that, nationwide, more people oppose the health-care reform law than support it.
Although Mr. Obama's biggest health-care challenge is defending his plan from foes on the right, he also faces critics on the left who say a stronger government role is needed to tame medical prices and ensure wider access to care.
In a new CNN/Opinion Research poll, 54 percent of Americans said they disapproved of the president's handling of health-care policy. When asked whether the law should remain as is, whether government's role should be strengthened, or whether the law should be scrapped and replaced with something completely different, 20 percent of Americans chose to "leave as is." Some 48 percent said "repeal and replace," and 30 percent called for an enhanced government role.
Public support for leaving the law as is has fallen 3 percentage points since CNN asked the same question in March.
In November, voters in Arizona and Oklahoma are scheduled to vote on ballot measures similar to the one in Missouri. But the votes may remain symbolic in nature. Legal scholars say it won't be easy for state laws to override the federal law.
A greater threat to the health reform law comes in the form of lawsuits that challenge its constitutionality. Earlier this week, a federal judge in Virginia allowed one of these lawsuits to go forward, challenging the individual mandate. Another lawsuit, filed in a Florida court, argues that the law requires states to expand Medicaid rolls without covering the added costs.
Another threat could come indirectly through the ballot box, if voters oust enough Democratic incumbents to shift the balance of power in Congress.
Many Americans support the concept of the individual mandate, as well as other aspects of Obama's plan. But many are also skeptical of whether the reforms will curb medical costs for them as taxpayers or as health-care consumers. Others worry the law will cause small employers to drop health benefits, forcing more people to buy insurance on a government-regulated exchange.