Backers get ready for vote on health care law

JEFFERSON CITY, Mo. -- Missouri is poised in August to become the first state in the nation to put the new federal health insurance law to a public referendum.

So there should be a major campaign, with commercials from the right attacking "Obamacare" with the left championing the biggest accomplishment of Barack Obama's presidency.

Right? Perhaps not.

Barely five weeks before the Aug. 3 election, backers of the Missouri ballot measure -- which seeks to defy a government mandate to have health insurance -- are just now beginning to raise money for a coordinated campaign. They still hope air some commercials and put up yard signs.

Opponents of the ballot measure only recently filed a lawsuit seeking to block it, but with no hearing scheduled, it's unclear whether a judge will rule before the election. So far, there is no organized campaign committee to urge people to vote "no." And there may not be one.

"I don't see much of any real opposition forming," said Jim Kottmeyer, a former executive director of the Missouri Democratic Party who has worked on other recent ballot measure campaigns.

At issue is legislation passed earlier this year by the Democratic-led Congress and signed by Obama that requires most Americans to have health insurance or face fines beginning in 2014. Businesses with more than 50 employees also could face fees beginning in 2014 if the government ends up subsidizing their workers' health insurance coverage.

Opponents of the law, which include many Republicans and tea party activists, contend the federal government has no right to make people buy a product -- namely, health insurance -- if they do not want to do so.

A measure referred to the August ballot by Missouri lawmakers proposes a state law asserting that people and employers cannot be compelled to have health insurance nor penalized for paying for their health bills with their own money.

Similar measures have been proposed, passed or referred to voters in several other states. But Missouri's will be the first to go to the ballot since enactment of the federal law.

If passed by voters, the legal effect of Missouri's measure is questionable. That's because courts generally have held that federal laws trump those in states.

That's one reason opponents have not yet organized to campaign against it.

"Everyone's sense is let's [watch] the lawsuit and then figure out if and how it makes sense to oppose it at the ballot box," said Jeff Ordower, interim director of the Missouri Progressive Vote Coalition, which supports the federal health care law. "Do you waste your resources on something that has no force of law, that is more about messaging?"

Another reason there may be scant opposition is the timing of the election. To avoid a filibuster by Senate Democrats, supporters of the Missouri referendum agreed to make a statutory change instead of a constitutional amendment and to place it on the August primary ballot instead of the November general election.

That means Republicans can't use the measure to drive up turnout of conservative voters for GOP candidates matched up against Democrats. In August, the most closely contested statewide and congressional primaries all are among Republicans.

"You've essentially got an initiative passed by the Republican Legislature, kind of written how they want to view the world on this issue, on the ballot in a Republican primary," Kottmeyer said.

Even so, opponents of the federal health care law view Missouri's referendum as a prime opportunity to send a message to Washington.

A group called Missourians for Health Care Freedom has been formed to finance the campaign. St. Louis area Sens. Jane Cunningham and Jim Lembke, two of the measure's sponsors, have been heading up the cash drive with help from a fundraising firm run by Republican consultant John Hancock. The group's first fundraiser was to take place Saturday at a home in Ladue.

Cunningham said she hopes to draw enough donations -- in chunks ranging from $25 to $25,000 -- to air TV and radio ads. Signs declaring "health care freedom YES! on proposition c" already have been designed. Spokespeople have been lined up in each of Missouri's main media markets. And Patrick Tuohey, who ran a pair of conservative initiatives that failed to make the 2006 ballot, has been hired to manage the campaign for the health care referendum.

Although he would like the Missouri ballot measure to spark national interest -- and a major campaign -- Tuohey is planning a practical approach in which supporters focus on getting like-minded people to show up on Election Day.

"I think really this is a get-out-the vote campaign," Tuohey said. "This is not something where it is necessary -- or frankly a good expense of money -- to try to convince people" who are undecided that they should vote for the Missouri referendum.

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EDITOR'S NOTE -- David A. Lieb has covered state government and politics for The Associated Press since 1995.