Health Care

2010

As Congress puts the finishing touches on a health insurance reform plan that will lower the cost of health care for our families, businesses, and government, national, right wing groups and Republican state legislators across the country are moving forward with proposals that obstruct solutions to our health care crisis.  These proposals would prevent citizens across the country from choosing to be a part of a reform plan that would guarantee choice of doctors and health plans, provide more security and stability to those who have health insurance, and offer affordable coverage for those who don’t have insurance.

Working under the illusion that a national, single payer, federal plan is being proposed and considered, which it is not, national right wing groups like the American Legislative Exchange Council  are organizing Republican state legislators into a “Tenther” movement that would prevent citizens from choosing to be a part of health insurance reforms.

Both state legislation and legislative referrals to the 2010 ballot are being proposed in a number of states. There are currently no efforts to place a citizen initiative on the ballot in any states.

The goal of the state efforts is to obstruct health insurance reform with frivolous lawsuits that constitutional scholars believe have little to no chance of winning.

“States can no more nullify a federal law like this than they could nullify the civil rights laws by adopting constitutional amendments,” said Timothy Stoltzfus Jost, a health law expert at Washington & Lee University School of Law.

Mark A. Hall, a law professor at Wake Forest University who has studied the constitutionality of mandates that people buy health insurance, said, “There is no way this challenge will succeed in court,” adding that the state measures seemed more “sort of an act of defiance, a form of civil disobedience if you will.”

To date, only one state, Arizona, has actually referred a constitutional amendment to the ballot. The so-called Arizona Health Care Freedom Act is virtually identical to one narrowly rejected by voters in 2008. 

2008

From BISC‐commissioned research going in to the 2008 election cycle, we knew that voters across the country were eager to advance health care reforms at the ballot box.

Next to rising energy and fuel costs, health care represented the largest factor contributing to the economic insecurity of Americans. The health care challenge continues to be about both cost and access, but more fundamentally it is about security.

In 2008, progressives advanced health care solutions in a number of states with tremendous success.

Montana

Montana passed by an overwhelming margin (70%-30%) a children's health care initiative that would extend health care coverage to all of the state's uninsured children. The Healthy Kids Plan Act (I-155) will provide comprehensive health coverage to the 30,000 uninsured Montana children who live in families that make up to about $50,000 per year.

Montana has one of the highest rates of uninsured children in America, yet Montana is one of only four states that had denied SCHIP coverage to kids above 175% of the federal poverty level.  The state also has the lowest income ceiling in America for covering kids under Medicaid.

The initiative passage will establish the Healthy Montana Kids plan to expand and coordinate health coverage for uninsured children under the Children's Health Insurance Program (CHIP), the Montana Medicaid Program, and employer-sponsored health insurance. It will allow the State Health Department to: raise income eligibility levels for children under CHIP and Medicaid; simplify transitions between CHIP and Medicaid coverage; provide assistance for children in employer-sponsored insurance; and work with health care providers, schools, organizations, and agencies to encourage enrollment of uninsured children.

Funding for I-155 will come from a share of the insurance premium tax and federal matching funds. The Healthy Montana Kids Plan will cover nearly all kids in Montana for about $20 million, a fraction of the state budget surplus, while bringing about $70 million in federal dollars into the state.

Supporters of the initiative, Healthy Montana Kids First, made the case to voters that parents of uninsured children are seven times more likely to delay getting medical treatment for their child and that the early, preventative treatment that insured children get is less expensive than the late-stage treatment that uninsured children get. For example, every dollar invested in immunizations saves $13 in future medical costs.

Missouri

Missouri voters passed a home health care initiative with 75% of the vote. The initiative will now enable the elderly and those with disabilities to continue living independently in their homes. The initiative, Proposition B, creates the Missouri Quality Homecare Council to ensure the availability of quality home care services under the Medicaid program by recruiting, training, and stabilizing the home care workforce.

Supporters of the measure, Missourians for Quality Home Care, effectively convinced voters that the state needed solutions to provide quality care for an aging population.

Washington

A Washington ballot initiative that will improve health care quality by requiring most long-term-care workers to be tested and certified by the state passed 73%-27%. The measure, covering long-term care workers for the elderly or persons with disabilities (I-1029), will require such workers to be certified as home care aides based on an examination, with exceptions; increase training and criminal background check requirements; and establish disciplinary standards and procedures.

A Death with Dignity initiative also passed in Washington with 59% support. The measure, Washington Death with Dignity Act (I-1000) would allow dying patients to control their own end-of-life care. Patients in the final stages of a terminal disease will now have the choice to end their life with dignity, on their own terms. Booth Gardner, a popular former governor, led efforts to pass the initiative in Washington eight years after the successful implementation of Oregon's Death with Dignity Law, which was recently upheld by the US Supreme Court ruling in Gonzales v. Oregon. Support for the initiative effort was strong with supporters raising nearly $5 million to pass the initiative despite substantial funding in opposition coming from religious organizations from out-of-state.

Michigan

Michigan decided whether stem cell research should be legal in the state, passing an initiative 53%-47%. The measure comes on the heels of a 2006 victory in Missouri where a similar ban was overturned. The Michigan initiative will overturn the state's ban on stem cell research. Forty-six states now currently allow such research.

Michigan law had made it a felony to use new embryonic stem cells - meaning embryonic stem cells that are leftover from fertility treatment - for research into cures for serious diseases and injuries. The passage of this measure will strengthen Michigan's ban on human cloning and allow researchers to use ethical means of seeking out new cures for diseases like Parkinson's, juvenile diabetes, spinal cord injuries, Alzheimer's disease and cancer. It will allow doctors and researchers to acquire embryos that would otherwise be discarded by fertility clinics as medical waste, and use them instead for finding cures and saving lives.

Right to Life of Michigan and the Michigan Catholic Conference opposed the measure and put significant resources towards its defeat.

Michigan voters also passed an initiative that legalizes marijuana use for the terminally and seriously ill.  Michigan becomes the 14th state to legalize medical marijuana for the treatment of a host of health problems such as HIV/AIDS, cancer, hepatitis C and Alzheimer's disease. Backers of medical marijuana got a big boost when the American College of Physicians, which represents 124,000 internal medicine specialists, issued a position paper that calls for expanded research into the potential therapeutic role of marijuana, noting that various medical, "reports suggest numerous potential medical uses for marijuana." 

Arizona

Voters in Arizona rejected Proposition 101, an initiative that was placed on the ballot to scuttle legislative efforts to expand the state's current health-insurance program to everyone in the state. Despite spending over $500,000, supporters of the initiative lost at the ballot box 50.2%-49.8%. While supporters tried to sell the initiative as way to protect health care choices, questions about the breadth of Proposition 101 led Gov. Janet Napolitano to take a vocal role in urging Arizonans to defeat it. The real effect of the proposal would have left the door open to an argument that the state's managed care organization could no longer pay private entities to provide care for the poor. The initiative could have also forced the state to move to a fee-for-service arrangement and could have possibly cost the state $1 billion a year.

Supporters say that the main purpose on the effort was to preclude lawmakers -- or voters -- from setting up a "single-payer' system similar to what exists in Canada and what is being tried in Massachusetts. They have vowed to try again in 2010.

Wisconsin

In Wisconsin, the city of Milwaukee passed a paid sick leave measure. This local referendum was modeled after successful referendums in San Francisco and Washington, D.C.  A coalition of labor, educational, and community organizations calling itself Paid Sick Days Milwaukee, led by 9 to 5, the National Association of Working Women, headed the effort.

The proposal allows a worker to earn a minimum of one hour of paid sick time for every 30 hours worked, which means full-time employees for a large business would earn 72 hours a year. Businesses with l0 or fewer employees would be required to provide 40 hours of paid sick leave a year. The days could be taken for illness, medical care for the worker, a child, parent, or other person related to the worker "by blood or affinity".

Nearly half of all workers nationally lack paid sick days. Only one-in-four low-income workers and one- in-six part-time and temporary workers have paid sick days, and some 85% of all food workers don't get paid sick days. Sen. Ted Kennedy (D-Mass.) has introduced federal legislation that would implement paid sick leave nationwide, and 9 to 5 has said it wants to use the Milwaukee referendum to build support for the bill.

Local health care reform referendums passed as they did in 2006. In 2006, thirteen local referendums passed with overwhelming support but the states have not yet acted on reform. The local referendums call on the legislature to act on comprehensive health care reform and guaranteeing health care comparable to what is provided to state lawmakers. This year an additional 22 cities and counties passed the referendums.

Maine

While progressives provided ballot initiatives that offered solutions on health care, special interests were successful in gutting the funding for Maine's first-in-the-nation universal health care program

In 2003, the state legislature passed, and Governor John Baldacci signed, a bi-partisan health care reform plan that seeks to expand coverage, hold down costs and improve the quality of health care in Maine. The reform was a landmark step towards a public-private partnership to provide universal access to health insurance. The reform plan had its funding mechanism revamped in the recently concluded legislative session.  New funding sources were approved, including a reasonable tax on beer, wine and the syrup used in soft drinks.

However, Maine, like 24 other states, has a provision in state statute that allows anyone who disagrees with action taken by the legislature to initiate a "People's Veto."  In this case, special interests from the big beverage industry placed an initiative on the ballot that would strip the funding for the health care reform plan and derail universal health care in the state.

In an effort to protect a few extra pennies added to the cost of beer, wine, and soda, the special interests who supported the initiative have threatened 18,000 working families with the loss of their health coverage, which would mean thousands of kids losing the preventive care they need. The measure passed 64%-36%.

Other health care related ballot measures:

A number of bonding and administrative measures that dealt with health care were also on the ballot this year and passed.

California

In California, Proposition 3 passed 55%-45%. The Children's Hospital Act authorizes $980,000,000 in general obligation bonds for construction, expansion, remodeling, renovation, furnishing and equipping of eligible children's hospitals.

New Mexico

New Mexico voters approved Bond Question A, 59%-41%. The measure will authorize the issuance and sale of senior citizen facility improvement, construction and equipment acquisition bonds. Bond Question C was also approved with 65% of the vote. It authorizes the issuance and sale of health facility improvement bonds to make capital expenditures for cancer research and treatment facilities, other statewide and regional health facilities, educational facilities for statewide dental services and public health and behavioral health facilities.

North Dakota

In North Dakota 59% of voters gave approval for Measure 3.  This initiated statutory measure will establish tobacco prevention and control advisory committee and an executive committee; develop and fund comprehensive statewide tobacco prevention and control plan; and create tobacco prevention and control trust fund to receive tobacco settlement dollars to be administered by the executive committee.