Taking the Initiative on Health Care

Legislative Initiatives Would Place "Right to Independent Medical Care" in Michigan Constitution

Three similar proposals introduced in the Michigan Legislature this year — House Joint Resolutions Z and CC, and Senate Joint Resolution K — would place recognition of a "Right to Independent Medical Care" in the Michigan Constitution. Specifically, they would establish that "every person has a right to provide for his or her own health care" and prohibit any law or rule that would directly or indirectly "compel any person, employer, or health care provider to participate in any health care system."  (SJR K and HJR CC only apply to federal laws or rules, while HJR  Z applies to any government mandate or ban.)

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With the U.S. Senate's passage of a massive federal intrusion into the health care choices of every citizen, interest in the Right to Independent Medical Care initiative is growing not just in Michigan, but in other states as well. The idea originated in Arizona, where the measure was barely defeated in a November 2008 popular vote. The Arizona Legislature has already voted to place the initiative on the 2010 ballot. Similar measures have been introduced or are being considered in at least 24 other states

It is unclear how state constitutional prohibitions against government health insurance mandates on individuals and employers would interact with the bills that have passed in the U.S. House and Senate, both of which contain such mandates. At the very least, this would probably result in some interesting court cases, and possibly a states-versus-Washington federalism smackdown. The federal legislation does not contain a ban on private medical care à la Canada, so the provision in these state initiatives prohibiting such a ban would not come into play at this time.

The initiatives also explicitly exempt from any constitutional ban state insurance coverage mandates and restrictions, many of which have contributed to the dysfunctions in our current health care system. Perhaps their greatest shortcoming as a defense against the health system takeover advancing in Congress is that they would not prohibit proposed federal insurance policy coverage mandates that are at the heart of "Obamacare" and are arguably its most destructive component, both in limiting health care choices and blowing massive holes in the federal budget for decades to come.

That said, if these proposed state constitutional limits did become effective they would probably make Obamacare unworkable for another reason: The huge insurance price increases that would result from these federal mandates would require massive subsidies to keep insurance affordable for middle income families. Limiting the cost of those subsidies is the real purpose of both the "individual mandate" and the "employer mandate" in the bills. Without them, the entire structure collapses.

The two versions of the initiative introduced by Republican representatives in the Democratic-controlled Michigan House are unlikely to be taken up, although the minority could seek a "discharge petition" to bypass the regular committee process and bring the resolution to final passage vote in the floor.

Some wonder why the GOP-controlled Senate has not already brought SJR K to a vote, given the unpopularity of the federal health care bills. Although unlikely to garner the two-thirds majority in both houses needed to place it on the ballot, a vote on Michigan's SJR K would force senators on both sides of the aisle to take at least a "proxy" position on the impending federal health care takeover.