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State Senate debates resolution to opt out of federal health care

This article first appeared in the St. Louis Beacon, March 25, 2010 State lawmakers engaged in a lively debate late into the evening Wednesday over a resolution calling for a constitutional amendment for Missourians to decide whether to opt out of federal health-reform legislation. A similar resolution already has cleared the House.

Some of the toughest questions about the state Senate proposal, called SJR25, sponsored by Sen. Jane Cunningham, R-Chesterfield, came from Sen. Rita Days, D-Bel Nor. Days asked repeatedly what would happen to the estimated 495,000 uninsured Missourians if the state opted out of the federal legislation and followed Cunningham's proposal.

"Right now, they can go to the emergency room," Cunningham said. "This bill doesn't prohibit them to do that."

Days responded, "Are you suggesting that we send 495,000 people to our emergency rooms?" She added that emergency rooms were the most expensive way to care for people and already were filled with people waiting for care.

Despite repeated questions from Days, Cunningham stuck by her general response that her proposal was offered to protect freedoms, let voters take a stand and allow them to continue to make their own choices about health care.

Sen. Joan Bray, D-University City, offered an abortion-rights amendment, reasoning that since the issue was supposed to be about health care freedom, it should logically include giving women the freedom of choice, including the right to abortion. Her amendment failed.

Senate Minority Leader Victor Callahan, D-Independence, argued that Republicans were misguided in claiming the federal health initiative was an unprecedented mandate from the federal government for citizens to buy a service. He said the federal will would prevail, just as it has prevailed on issues such as Social Security.

"I pay Social Security taxes," he said, adding nothing in the Constitution called for that service, which was set up in 1936 during the New Deal.

"I never got to vote on whether the federal government should (impose a tax) for Social Security. That wasn't by popular vote. So can the state of Missouri exempt citizens out of the Social Security system?"

Though Republicans seemed united in favor of the measure, it was not immediately clear how many Democrats, if any, would support it. If the House's example is a guide, the measure could get some bipartisan support.

The version of the bill debated on the Senate floor states:

"Upon voter approval, this constitutional amendment provides that no federal law shall compel a patient, employer or health-care provider to participate in any government or privately run health care system, nor prohibit a patient or employer from paying directly for legal health-care services.

"This amendment does not affect laws or regulations in effect as of Jan. 1, 2010, affect which health-care services a health-care provider is required to perform, affect which health-care services are provided by law, or prohibit care provided under worker's compensation."

Following debate Wednesday night, the bill remained on the Senate's informal calendar for perfection and is expected to be taken up again next week.

During last week's 109-46 House vote in favor of a similar proposal, about two dozen Democrats sided with the Republicans. These included several Democratic lawmakers from suburban St. Louis: Kenny Biermann of St. Charles, Ron Casey of Crystal City, Vicki Englund of St. Louis, Michael Frame of Eureka, Michele Kratky of St. Louis, Albert Liese of Maryland Heights, Tim Meadows of Imperial, and Sue Schoemehl of Oakville.

Funding for health reporting is provided in part by The Missouri Foundation for Health, a philanthropic organization whose vision is to improve the health of the people in the communities it serves.

Robert Joiner has carved a niche in providing informed reporting about a range of medical issues. He won a Dennis A. Hunt Journalism Award for the Beacon’s "Worlds Apart" series on health-care disparities. His journalism experience includes working at the St. Louis American and the St. Louis Post-Dispatch, where he was a beat reporter, wire editor, editorial writer, columnist, and member of the Washington bureau.

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