Does Prop. 106 protect rights, or is it useless?

By JENNIFER A. JOHNSON
Cronkite News Service

PHOENIX – Supporters of Proposition 106 say allowing Arizonans to opt out of any federal or state health care mandate would preserve the right of individuals to make their own decisions.

Opponents, however, say the measure could derail the benefits of federal health care reform here if the state can defend it in court. But they say that since a federal plan would trump anything at the state level Proposition 106 would most likely set Arizona up for a costly and unsuccessful legal battle.

The proposition, dubbed the Arizona Health Care Freedom Act, would amend the state constitution to allow Arizonans to opt out of health care mandates.

“It is critically important that we vote to keep patients and families in control of their health care decisions and not politicians, and those protections deserve a place alongside freedom of the press and freedom of speech,” said Eric Novack, a Glendale orthopedic surgeon who serves as chairman of Arizonans for Health Care Freedom, the main group supporting Proposition 106.

The Legislature referred the measure to the ballot in 2009 as Congress was debating health care reform. Supporters anticipated that the federal law would include the government offering a health care plan, or public option, but that was dropped.

As of 2014, the federal plan will require employers to offer health coverage and will require individuals who aren’t otherwise covered to purchase insurance, though there are some exemptions for those with low incomes.

Arizona is among 20 states suing the federal government over the law.

Proposition 106 also would allow individuals to pay directly for any legal health care service without facing penalties or fines.

“If a health care service is legal … no one should ever prevent you from getting access to legal health care services,” Novack said.

Novack’s group had raised $1.9 million through Sept. 13, according to the Arizona Secretary of State’s Office. Of that, $1.5 million came from the U.S. Health Freedom Coalition, a national advocacy group of which Novack is chairman.

Two opposition groups had raised less than $4,000 between them.

The measure is similar to a 2008 ballot measure, also pushed by Novack, that failed by a narrow margin. Opponents suggested that that measure would deny low-income Arizonans access to the state’s Medicaid system.

Similar ballot measures are pending in Virginia, Missouri, Idaho, Georgia and a handful of other states.

Proposition 106′s sponsor, Rep. Nancy Barto, R-Phoenix, said the measure gives voters another opportunity to challenge the individual freedoms she contends are threatened by the national health care law.

“I think we all agree that health care needs reform,” Barto said. “Proposition 106 is a guarantee about who is going to control your health care decisions, and it keeps those decisions in the hands of patients and families.”

The National Federation of Independent Business has also backed Proposition 106, citing concern that the federal plan will place regulatory burdens on small businesses and restrict their ability to choose the kind of plan designs they can afford.

“Health care has been the top issue for the past decade that small businesses have been wrestling with,” said Farrell Quinlan, the group’s Arizona director. “Small businesses want to be able to provide health care to our employees, but we find that mandates make it harder and harder to provide the kind of coverage we want to provide.”

Rep. Kyrsten Sinema, D-Phoenix, the House minority leader, called the measure “useless” in the face of the federal plan.

“Arizona will end up in costly litigation, and we should be using that money for our schools,” she said.

Sinema said that opponents of the federal health care law should elect members of Congress who will address their concerns, not attempt to change what they can’t control at the state level.

Ellen Owens-Summo, president of the Arizona Public Health Association, said that the proposition would set back many of the preventative health measures that are in the federal law.

“I think we are kind of pulling apart the pieces [of the national health care law] when we need to address the foundation of health care, which is promotion, prevention and workforce development,” she said.

Pete Cerchiara, executive director of an opposition group calling itself Prop 106 Endangers Your Health, said he worries that the proposition would interfere with a law that will help millions of Americans without health insurance.

“When people who aren’t insured can’t pay their bills, we all share in the costs,” he said. “[Proposition 106] is only encouraging more people to be uninsured.”

Key provisions of Proposition 106:
(From Arizona State University’s Morrison Institute for Public Policy)
- Allow individuals and employers to pay providers drectly for health care without penalty or fine.
- Prohibit any rule or law from compelling individual participation in any particular health care system.
- Allow direct payment to a health care provider for any lawful service.
- Provide for purchase and sale of health insurance in private health care systems without prohibition by rule or law.