Judge revises wording for Mo. health care measure

JEFFERSON CITY, Mo. -- A Missouri judge ruled Tuesday that Democratic Secretary of State Robin Carnahan had provided an unfair and insufficient summary of a health care ballot measure to appear before voters this fall and instead ordered election authorities to use an alternative description backed by Republicans.

The ruling marked a victory for Lt. Gov. Peter Kinder and fellow Republicans in the legislature, who referred the measure to the November ballot but then sued to contest the summary drafted by Carnahan's office. The ballot measure focuses on "health insurance exchanges," the online marketplaces required under President Barack Obama's health care law.

Cole County Judge Dan Green heard arguments Tuesday in the lawsuit and later issued a brief, two-page ruling declaring that "the ballot summary prepared and certified by Secretary of State Robin Carnahan is not fair and sufficient." Green did not elaborate on the reasons leading him to that conclusion.

Carnahan's original ballot summary stated: "Shall Missouri law be amended to deny individuals, families, and small businesses the ability to access affordable health care plans through a state-based health benefit exchange unless authorized by statute, initiative or referendum or through an exchange operated by the federal government as required by the federal health care act?"

Attorney Jay Kanzler, who represented Republican officeholders in the lawsuit, had argued to the judge that the state cannot deny Missourians access to health insurance exchanges, regardless of what happens to the measure in the November election.

"To use the word 'deny' where something can never be denied is illogical unless its use was intended to mislead or influence the voters against the ballot proposal," Kanzler had said.

Green ordered Carnahan to use a revised ballot summary that had been suggested by the Republican plaintiffs. The new summary states: "Shall Missouri law be amended to prohibit the Governor or any state agency, from establishing or operating state based health insurance exchanges unless authorized by a vote of the people or by the Legislature?"

Kinder praised the swift ruling as "an enormous victory for Missouri voters" that "gives proof to the clear bias in Carnahan's summary."

"Judge Green's ruling substantiates our claim that Secretary Carnahan's ballot summary does not pass the laugh test," Kinder said in a written statement.

Carnahan's office said Tuesday that the original summary is fair and sufficient and the revised version would "provide Missouri voters with less information about the impact of the proposal and how Missouri individuals, families and small businesses can access affordable health care." Officials said they are reviewing the decision to determine the next step.

During court arguments Tuesday, Deputy Solicitor General Jeremiah Morgan had defended the summary. He said it was clear that in passing the measure, lawmakers were trying to "squeeze" efforts to establish a state-based insurance exchange and possibly a federal exchange.

The federal health care law, which Obama signed in 2010, requires states to either create their own health insurance exchanges by 2014 or else the federal government will run one for them.

If approved by voters, the Missouri ballot measure would bar the governor or other Missouri officials from creating a health insurance exchange without approval from voters or the legislature.

It also would prohibit state departments from taking federal money to set up the online marketplace, which is intended under the federal health care law to help consumers shop for and compare insurance plans.

A spokeswoman for Attorney General Chris Koster, whose office defended the ballot summary, had no immediate comment on whether the ruling would be appealed.

Morgan had argued that simply because a summary could be written differently -- or even arguably more accurately -- did not mean it was insufficient or unfair.