No matter what the federal government winds up doing about health care, the people of Arizona will be able to vote in 2010 to retain their right to the health plan of their choice.
In June the Arizona legislature voted to place the Arizona Health Freedom Act on the ballot for voter consideration, six months after an earlier version of the initiative failed by fewer than 9,000 votes. If the measure passes, a new constitutional amendment will protect Arizonans' right to spend their own money on any legal health care service and to opt out of any health care system imposed upon them.
Whether they would in practice have the right of exit from federal health care programs is a question that would be settled by the courts. State nullification of federal law has an awkward and difficult history, dating back to attempts by Kentucky and Virginia to ignore the Alien and Sedition Acts in the 1790s and South Carolina's unsuccessful efforts to ignore two federal tariffs in the 1830s.
Still, the recent history of the Real ID Act, a homeland security measure that was scuttled by state resistance, suggests that if other states follow Arizona's lead, their coordinated action could prove fatal to national health mandates. Christine Herrera, who tracks health care issues for the conservative American Legislative Exchange Council, says similar bills are being considered in at least five more states.