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Health Care Measure Back on the Ballot

Proposition 106: Arizonans will vote yes or no on federal health mandate

Arizonans have an opportunity on Nov. 2 to voice their support or opposition to the new national health care law.

Proposition 106 is a retooled replay of a 2008 ballot measure on health insurance mandates that lost by the slimmest of margins. Proposition 106 supporters hope passions about the health care reforms passed by Congress earlier this year will lift 106 to victory; AARP Arizona and other opponents urge a no vote on Proposition 106.

Under the federal law, health insurance companies cannot deny coverage for preexisting conditions or cancel policies when people get sick. To make the provisions economically feasible for the insurance companies, it requires everyone to have insurance.

That's where the controversy begins. Critics see that provision as a dangerous expansion of federal power over individual lives, while supporters see it as a welcome expansion of full-participation programs like Social Security and Medicare.

Proposition 106 would amend the state constitution to bar any rules or regulations that force Arizonans to participate in a health care system or plan.

"Family health care decisions shouldn't be made by bureaucrats 3,000 miles away," said Eric Novack, a Glendale orthopedic surgeon who leads efforts for 106, as he did for the 2008 measure.

Prescott nurse Nancy Martin, a leader in the fight to defeat Proposition 106, is co-chair of the Arizona Coalition for a State and National Health Plan. She said bureaucrats far away are already making our health decisions, but they are insurance company bureaucrats looking to generate profits. "The 'vote yes' people are saying that our health care decisions shouldn't be made thousands of miles away," Martin said, "but isn't that already the problem?"

Leonard Kirschner, AARP Arizona state president, said AARP opposes 106 because "it does nothing to improve the three critical issues we need to deal with in our dysfunctional health care system: accessibility, affordability and accountability." He added, "Proposition 106 is part of a larger national political movement to subvert the national health care plan. But the plan is needed by many 50- to 64-year-olds who now have trouble getting health insurance coverage because of preexisting conditions."

George Pauk, a retired Phoenix internist opposed to 106, worried that allowing people to opt out of public health programs could be disastrous in a major health crisis. He also said the measure, coming in the wake of the state's immigration law uproar, could further define Arizona as politically backward. "It will say Arizona is an anachronism — not trying to be part of the United States," he said.

Gov. Jan Brewer, R, who is running for reelection, has endorsed 106, saying that it "provides a very clear message in opposition to new federal health care cost burdens and mandates."

Proponents of Proposition 106 are more optimistic about victory this time because there is no well-financed "vote no" campaign and because voters are more focused on the issue now than in 2008.

John Rivers, president and CEO of the Arizona Hospital and Healthcare Association, predicted the vote will be irrelevant because of expected legal challenges.

"The issue is clearly going to be decided in federal courts, not in the ballot box," he said. His association as well as the insurance industry declined to get involved in the 106 campaign. Blue Cross Blue Shield of Arizona, one of the state's largest insurance companies, is worried about unintended consequences of the proposition, said Kathi Beranek, manager of BCBS government relations. "Everyone needs to be in the pool," she said. "If you eliminate the individual mandate but still imposed all the regulations under the federal health care law, it would be detrimental to the insurance market."

Clint Bolick, legal director of the conservative Goldwater Institute, welcomes the legal fight.

"This is an opportunity to blaze new trails for individual freedom and state autonomy," Bolick said. "I would love to have the opportunity to take it to the Supreme Court."

Similar measures, modeled after Arizona's, will appear on the Oklahoma and Colorado ballots. In August, Missouri voters resoundingly rejected the federal mandate; it was the first election test of the law.

The full text of Proposition 106 is available on the Arizona Secretary of State's website.

Maureen West is a freelance writer based in Phoenix.

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