Prop C makes Missouri the ‘Show-Them’ state

Nation awaits state’s Aug. 3 vote on federal health care law opt-out, a ‘last-ditch’ political ploy, WUSTL expert says

Three states are looking to Missouri to show them — and the nation — the first results of a referendum on federal health care reform.

Arizona, Florida and Oklahoma will be watching closely the results of the Aug. 3 vote on Proposition C, which would allow Missourians to opt out of a federal mandate for individuals to purchase health insurance starting in 2014.

The three states will follow Missouri in letting voters have their say about the Barack Obama administration’s health care law. But in any state, the ballot measure is pure politics, according to Timothy D. McBride, PhD, professor and associate dean for public health at the Brown School at Washington University in St. Louis.

“It is obvious that this is a last-ditch attempt by politicians who lost the debate on health reform in Congress to defeat it after the fact,” McBride says.

Win or lose, Prop C won’t stand

Proposition C will have no impact even if it is approved by Missouri voters because the supremacy clause of the U.S. Constitution holds that federal law takes precedence over state statutes. Should the measure pass, it will be withheld from implementation until an inevitable court ruling on its unconstitutionality.

“We have legal procedures in this country to make sure that laws passed by the Congress cannot be superseded,” McBride says. “And this is what will happen to this proposition if it is passed.”

Measure ignores essential aspects of health care reform

Proposition C — if passed — is not only certain to be found unconstitutional, it also falls short by omitting more important portions of the federal health care reform law, McBride says. Proposition C’s single focus underscores its purely political intent, he says.

“By far the most important aspects of health reform are the health insurance regulations, repealing the bad practices of health insurers and the provisions to set up health insurance exchanges where individuals can find affordable insurance,” McBride says.

McBride, a leading health policy analyst and health economist, has written extensively and testified before Congress about health policy matters.

For interviews, please contact Nancy Fowler Larson at until Jessica Martin returns Sept. 7, 2010.

Expert contact information: Timothy McBride, 314-935-4356,