Reform opponents think states' votes on mandate will strengthen their case

While Arizona, Colorado and Oklahoma all will officially challenge the health reform law on a constitutional level at the ballot box tomorrow--specifically the provision requiring everyone to buy health insurance starting in 2014--it's not clear whether those challenges and others, if successful, will actually mean anything in the grand scheme of things, Kaiser Health News reports. 

Essentially, opponents of the health reform law are hoping that when viewed en masse, states' challenges from around the nation will paint a picture of dissatisfaction too big to ignore. Currently seven states--Georgia, Idaho, Louisiana, Missouri, Utah, Virginia and the aforementioned Arizona--all have passed bills amending their states' laws [not their constitutions] to make a health insurance mandate illegal, according to the National Conference of State Legislatures. Tomorrow's votes would affect the constitutions of the three states involved. 

What's more, members of at least 40 states, so far, have expressed apprehension with the reform law, proposing opposing legislation, NCSL stated. 

"As more and more states pass these kinds of's going to embolden legislative action to repeal or defund legislative provisions [of health reform]," Robert Alt, deputy director of the Center for Legal and Judicial Studies at the Heritage Foundation, told KHN

Still many, including RAND Corp. associate director Elizabeth McGlynn, think those efforts could all be for naught considering that the Supreme Court ultimately will decide whether the law is constitutional. 

"To me, [the challenges are] more of a polling statement," she told KHN. "It's not clear to me in this case that the federal law wouldn't override state mandate...that will be something the courts decide....It's not really clear to me what that does at the state levels." 

In Colorado, the situation is especially sticky, considering that voters could be confused about what they actually are voting for, according to Alec Harris of the Colorado Center on Law and Policy, a group that opposes the amendment. There, the amendments only apply to "state efforts" to enforce any new rules, according to KHN

"It's getting billed as--and people seem to view it as--a referendum on federal health reform," Harris told KHN. "This has no ability to do anything about federal health reform." 

For more information:
- read this Kaiser Health News article
- check out this NCSL piece
- here are the actual amendments being voted on by Arizona, Colorado and Oklahoma