Missouri voters on Tuesday overwhelmingly rejected a key provision of President Barack Obama's health care law, sending a clear message of discontent to Washington and Democrats less than 100 days before the midterm elections.
With about 70 percent of the vote counted late Tuesday, nearly three-quarters of voters had supported the measure.
Tuesday's vote approving the ballot measure, known as Proposition C, was seen as largely symbolic because federal law generally trumps state law. But it was also seen as a sign of growing voter disillusionment with federal policies and a show of strength by conservatives and the tea party movement.
Legislatures in Arizona, Georgia, Idaho, Louisiana and Virginia have passed similar statutes, and voters in Arizona and Oklahoma will vote on such measures as state constitutional amendments in November. But Missouri was the first state to challenge aspects of the law in a referendum.
Missouri's law prohibits the government from requiring people to have health insurance or from penalizing them from paying for their own health care. That would conflict with a federal requirement that most people have health insurance or face penalties starting in 2014.
Federal courts are expected to weigh in well before the insurance provision takes effect about whether the federal health care overhaul is constitutional.
The intent of the federal requirement is to broaden the pool of healthy people covered by insurers, thus holding down premiums that otherwise would rise because of separate provisions prohibiting insurers from denying coverage to people with poor health or pre-existing conditions.
But the insurance requirement has been one of the most contentious parts of the new federal law. Public officials in well over a dozen states, including Missouri, have filed lawsuits claiming Congress overstepped its constitutional authority by requiring citizens to buy health insurance.
The Missouri Hospital Association spent $400,000 warning people that passage of the ballot measure could increase hospitals' costs for treating the uninsured, but there was little opposition to the measure from either grass-roots organizations or from the unions and consumer groups that backed the federal overhaul.
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