AT A GLANCE
AMENDMENT 9 —
Sponsor/originator: Florida Legislature
Title on ballot: Health Care Services
Official Summary: Proposing an amendment to the State Constitution to ensure access to health care services without waiting lists, protect the doctor-patient relationship, guard against mandates that don't work, prohibit laws or rules from compelling any person, employer, or health care provider to participate in any health care system; permit a person or an employer to purchase lawful health care services directly from a health care provider; permit a health care provider to accept direct payment from a person or an employer for lawful health care services; exempt persons, employers, and health care providers from penalties and fines for paying directly or accepting direct payment for lawful health care services; and permit the purchase or sale of health insurance in private health care systems. Specifies that the amendment does not affect which health care services a health care provider is required to perform or provide; affect which health care services are permitted by law; prohibit care provided pursuant to general law relating to workers' compensation; affect laws or rules in effect as of March 1, 2010; affect the terms or conditions of any health care system to the extent that those terms and conditions do not have the effect of punishing a person or an employer for paying directly for lawful health care services or a health care provider for accepting direct payment from a person or an employer for lawful health care services; or affect any general law passed by two-thirds vote of the membership of each house of the Legislature, passed after the effective date of the amendment, provided such law states with specificity the public necessity justifying the exceptions from the provisions of the amendment. The amendment expressly provides that it may not be construed to prohibit negotiated provisions in insurance contracts, network agreements, or other provider agreements contractually limiting copayments, coinsurance, deductibles, or other patient charges
Arguments for: Backers of the proposed amendment said it was a states' rights issue. Simply put, they argued that the federal government cannot force residents to purchase health insurance. "Are we now talking about freedom being unconstitutional?” asked Rep. Scott Plakon, R-Longwood, while debating the bill. They also argued that the new law will raise taxes. Skyrocketing Medicaid costs are reason enough to prevent the federal mandate, they argued, pointing to estimates that the program will cost far more than the $900 billion estimated by federal economists. "It's a budget-busting mess," said Rep. Mike Horner, R-Kissimmee.Arguments against: Critics said statements being made by the amendment's backers were misleading and shortsighted. For one thing, they said, charges that the reform legislation amounts to a government takeover of health care ignore the fact that Medicare and Medicaid programs are already operated by the government. Further, many argued that the Supremacy Clause of the U.S. Constitution clearly asserts that federal law trumps a state's ability to opt out. "This is, unfortunately, an ideological frolic," said Sen. Dan Gelber, D-Miami Beach.
Update
HOW WE GOT HERE: Congress passed a health-care reform bill that raised questions about whether individuals have a fundamental right to health care, and whether the government can force people to buy insurance.
THE LATEST: The Florida Legislature voted in April to place a proposal on the ballot asking voters to nullify the federal requirements of the health reform legislation. In addition, Florida's attorney general sued the federal government over the measure. The federal government then asked a judge to dismiss that lawsuit. Meanwhile, on July 2, four Florida voters filed suit against the amendment on the grounds its ballot language is misleading. On July 23, a circuit judge rejected a request to place on the ballot the entire proposal instead of relying on a ballot summary, which opponents contend is politically charged and inaccurate. On July 29, a circuit judge sided with the four Florida voters and struck the measure from the ballot, calling the ballot language "misleading." On Aug. 3, The 1st District Court of Appeal, without ruling, forwarded an appeal of the judge's decision to the Florida Supreme Court. On Aug. 18, the Supreme Court heard arguments from both sides. On Aug. 31, the Supreme Court upheld the lower court, effectively removing the proposed amendment from the ballot.
WHAT HAPPENS NEXT: The proposed amendment will be removed from the ballot.
BULLETIN: AMENDMENT REMOVED FROM BALLOT
Florida Supreme Court upholds lower court Read opinion here
HEALTH-CARE REFORM CHALLENGE
Amendment 9 Sought to Nullify Federal Requirement that Individuals Carry Insurance
Does federal healthcare law legally trample states' rights and surpass federal authority to regulate interstate commerce?
Concerns over federal efforts to reform health care led the Florida Legislature in April 2010 to approve a proposed constitutional amendment (HB 37) that backers said would nullify federal efforts to require individuals to carry health insurance.Supporters said the federal health-care law passed by Congress in March was unconstitutional because it illegally tromped on states' rights and went beyond the federal authority to regulate interstate commerce.
Passed by both the Florida House and Senate along party lines, the proposed amendment was headed to the November ballot until a circuit judge agreed with opponents who argued the ballot language was misleading. On July 29, the judge struck it from the ballot. The judge's decision was appealed to the Florida Supreme Court, which upheld the lower court on Aug. 31, striking the amendment from the ballot.
The proposed amendment
The amendment would have prevented any government from requiring that individuals, employers or health-care providers participate in any health care program. The proposal would have exempted programs already in effect, which would include Medicare and Medicaid. The proposal would have allowed patients to pay their health-care providers directly instead of going through a third-party insurer.To see the text, click here.
History
The first major federal entrance into the health care field occurred in 1965, with the creation of Medicaid and Medicare. Since then, there have been several attempts to expand the government's role further. President Bill Clinton attempted in 1993 to create a national health care system. The measure met with stiff opposition from states, insurers and the health care industry, and the proposed legislation died in 1994. Currently, more than 46 million U.S. citizens lack health-care coverage, including nearly 3.7 million Floridians.Following his election in 2008, President Barack Obama launched another attempt to establish some type of national health care system. Following months of intense debate and lobbying from all sides, Congress passed national health-care reform on March 21, 2010. Obama signed the health care law (PL 111-148) and the reconciliation bill (HR 4872) into law on March 23. Under the law, most Americans will be required by 2014 to purchase insurance or pay a penalty. The law also lowers the preventive care and prescription drug costs for Medicare recipients and offers free preventive services to adults and children on Medicaid.
For a look at how the bill might affect you, read this article.
The bill's passage prompted an immediate flurry of legal action.
Florida joined 12 other states in suing the federal government over the measure. Florida filed suit in U.S. District Court in Pensacola, saying the proposal was an illegal expansion of federal authority that unlawfully usurped states' rights.
To read the lawsuit, click here.
At least nine state legislatures around the country are considering amendments to their respective constitutions to nullify the federal effort. On April 22, the Florida House passed its measure on a 74-42 vote. Here's the roll call.
The Florida Senate followed suit four hours later, approving the measure by a vote of 26-11. Here's the roll call.
Supporters of the amendment
Backers of the proposed amendment argued that the federal government cannot force residents to purchase health insurance. "Are we now talking about freedom being unconstitutional?" asked Rep. Scott Plakon, R-Longwood, while debating the bill. They also argued that the new law will raise taxes. Skyrocketing Medicaid costs are reason enough to prevent the federal mandate, they argued, pointing to estimates that the program will cost far more than the $900 billion estimated by federal economists. "It's a budget-busting mess," said Rep. Mike Horner, R-Kissimmee.Opponents of the amendment
Critics said statements being made by the amendment's backers were misleading and shortsighted. For one thing, they said, charges that the reform legislation amounts to a government takeover of health care ignore the fact that Medicare and Medicaid programs are already operated by the government. They claim the measure was a veiled attempt to get conservative candidates to the polls in November. In deciding to strike the measure form the ballot, Leon County Circuit Judge James Shelfer called it "manifestly misleading," agreeing with opponents that several statements in the amendment's summary ballot language were not addressed in the amendment itself.Further, opponents argued that the Supremacy Clause of the U.S. Constitution clearly asserts that federal law trumps a state's ability to opt out. "This is, unfortunately, an ideological frolic," said Sen. Dan Gelber, D-Miami Beach.