States push back.

• Author: Cauchi, Richard
• Position: On the Health Care Reform Bill, 2010

With divisions well-defined in Congress over the federal overhaul of health care, it is no surprise that some legislators are pressing for states to redefine or opt out of parts of the overall plan.

In the past 12 months, a flood of proposed "anti-reform" state plans and constitutional amendments have been filed in at least 39 states, gaining widespread attention and stirring debate about state powers and federal preemption. Almost all focused on opposing the requirement that everyone have health insurance, suggesting instead that residents be given a choice whether to have health insurance, with no state penalties for choosing not to.

Three states--Arizona, Florida and Oklahoma-will have constitutional amendments onthe 2010 ballot.

So far this year, three other states enacted laws that primarily focus inward:

* Utah's statute prohibits any state agency from making health system changes unless the Legislature approves.

* Virginia added a provision called "Health insurance coverage not required" that bars state penalties or fines for not complying with any federal requirement.

* Idaho requires residents "be free to choose or decline to choose any ... health care services without penalty," while "no state official shall enforce" federal health mandates.

Virginia lawmakers were first to pass a law with five Democratic votes providing the critical majority. Senator Fred Quayle, a Republican who is the Senate sponsor, said the individual mandate is unprecedented. "I don't think in the entire history of this country there has ever been any act of Congress requiring a citizen to buy anything."

Delegate Jennifer McClellan, a Democrat who opposed the bill, says, "If a...