Despite Missouri Vote, Nullification Continues to Fail Across the Country

Health care nullification forces scored a symbolic victory in Missouri Tuesday as voters supported a ballot initiative to block the individual mandate portion of the federal health care law. But it was a primary electorate dominated by GOP primary voters-- and the real story is how isolated this victory has been for the repeal forces.

Early in the year, groups like the American Legislative Exchange Council (ALEC) announced that dozens of states were introducing legislation intended to "stop Obamacare at the state line." Yet aside from a handful of states, these measures were defeated across the country, even in conservative regions. In total, 26 states and counting have rejected health care nullification legislation, while at the same time, even the most right-wing state governments are moving forward on implementing the new law for the benefit of their citizens, as documented at

While a mere handful of states (colored blue in the graphic) have actually enacted nullification measures, ALEC-style or proposed constitutional amendments similar to Missouri's have failed in Alabama, Alaska, Arkansas, Colorado, Delaware, Illinois, Indiana, Iowa, Kansas, Kentucky, Maryland, Michigan, Minnesota, Mississippi, Nebraska, New Hampshire, New Mexico, North Carolina, North Dakota, Rhode Island, South Dakota, Tennessee, West Virginia, Washington, Wisconsin, and Wyoming. In Louisiana, Gov. Jindal signed into law an admittedly symbolic measure (HB 1474) that specifically stated that "no provision... shall be interpreted or held to supercede any provision of the Patient Protection and Affordable Care Act of 2010... or any other federal law."

In Florida, the conservative-dominated legislature passed a health care nullification amendment earlier this year that was to be voted on in November, but that measure was recently thrown off the ballot by a judge who ruled that the ALEC-inspired language in the amendment was "manifestly misleading." Arizona and Oklahoma are also due to vote on ballot measures this fall.

At the same time the right wing is focused on grandstanding and political gamesmanship, legislators and officials in all 50 states are moving forward with the hard work of planning the effective implementation of the Patient Protection and Affordable Care Act at the state level. Many of these efforts began well before the passing and signing of federal reform and will accelerate as responsible leaders in the states focus on delivering quality, affordable health care to their constituents. Even right-wing state governments in states with high opposition to the health care law -- from Utah to Texas -- are working on implementing the new law as they rhetorically oppose it.

ALEC and its allies claimed a goal of defeating Obamacare in the 26 states where they've since been defeated. If they are going to own victory in Missouri, they should own up to defeat in all the other states as well.