Health Care Reform Sentiment – Beyond Missouri

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Today, Republicans are celebrating the fact that Missouri voters just overwhelmingly approved a state anti-health reform ballot initiative. The measure, which says Missouri residents can’t be required to maintain health insurance, is largely symbolic since federal law trumps state law. There was almost no organized opposition to the measure and the various races in the state likely drew out more Republican voters. (The primaries are not closed – voters choose which party ballot to use at the polling sites – but about 600,000 Missourians cast ballots in the Republican Senate primary compared to about 300,000 in the Democratic Senate primary.)

Nonetheless, that such an initiative garnered 71% of the vote says much about the strength of opposition to the new Patient Protection and Affordable Care Act. This was the first chance voters had to directly weigh in on the new law. This handy map from the Missouri secretary of state shows the ballot measure, known as Prop C, got the majority of votes in all but two counties – those containing Kansas City and St. Louis.

But despite all the Republican celebration we’re likely to see today – the Sarah Palin tweets and the Michael Steele victory lap – another vote tally from last night is also worth considering. In Kansas, incumbent insurance commissioner Sandy Praeger soundly beat Tea Party favorite Dave Powell to win the Republican primary. Praeger dramatically outspent her opponent and has more name recognition – she’s already served two terms – but she’s a moderate Republican who prevailed against the conventional wisdom you’ll hear today.

More significantly, Praeger beat back her conservative primary challenger despite that fact that she is working hard to ensure that the new health reform law is implemented as its Democratic authors intended. Praeger is head of the health insurance committee at the National Association of Insurance Commissioners. Her committee is currently working feverishly to come with, for example, definitions and language that will determine which expenses health insurance companies will be able to classify as medical care under the new law. This will, in turn, help determine the premiums they charge. Praeger is, in other words, deeply involved in moving the ball forward on federal health reform. And Kansas Republican voters have confidence in her.

The lesson here is that when pundits try to extrapolate national sentiment based on one state vote tally – like for Missouri’s Prop C initiative – this is bluster, not analysis.

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