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Mixed results in state votes on health insurance mandate

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In a limited test of public opinion on a key provision in the U.S. health care reform law, voters in Arizona and Oklahoma have approved ballot initiatives to invalidate a federal requirement that individuals be enrolled in a health care plan, while voters in Colorado defeated a similar initiative.

Under the federal health care reform law, effective in 2014, individuals must have health care coverage or be fined, while employers with at least 50 employees must offer qualified coverage or face a $2,000-per-employee fine.

Arizona Proposition 106, approved by about 55% of voters on Tuesday, would amend the state constitution to bar requirements that would force state residents to participate in a health care plan.

Oklahoma Health Care Freedom Amendment State Question 756, approved by about two-thirds of voters, would consider any law requiring state residents or employers to participate in a health care plan to be unconstitutional.

Colorado Health Care Amendment 63, rejected by about 55% of voters, would have given state residents the “right of health care choice” and overturn any law that requires individuals to buy health insurance.

While an indicator of voter sentiment, the ballot initiatives would have had no practical effect because federal law pre-empts state law under the U.S. Constitution.

However, several courts have yet to rule on lawsuits filed by health care reform opponents that allege that Congress lacked the authority to impose health care coverage mandates.

Meanwhile, in Massachusetts, where a 2006 law has achieved near-universal coverage by requiring most individuals to have coverage and imposes fines on all but very small employers that do not offer coverage, incumbent Gov. Deval Patrick, a strong proponent of the law, easily won re-election Tuesday. He defeated former health care executive Charles Baker.