Florida's Amendment One Asks Voters To Decide How Far State Can Go In Deciding Healthcare Policy

Sep 14, 2012

This November, Florida voters will have to decide more than just who they want to be the next President of the United States. They’ll also have to choose whether to add up to 12 different amendments to Florida’s Constitution. The proposals cover everything from how education dollars are spent, to who gets additional property tax exemptions. And the first thing voters will be asked to decide is, how far should government go when deciding healthcare issues?

“It’s rather symbolic. Not going to impact the affordable care act on the national level, it’s a feel-good amendment but doesn’t make a lot of sense.”    Charlie Benz is a retired Tax Auditor and volunteers as a caddy at Tallahassee’s Seminole Golf Club. He says he’s not in favor of Florida’s Amendment One, which voters will see on the November ballot. But not everyone shares that opinion.

“I don’t think the legislature should be able to mandate healthcare for every individual in the state of Florida. I think the free market should be able to work that out,” said Tallahassee resident Jimmy Nastassi.

Amendment One, also known as “Health Care Services”, began its journey to the ballot two years ago. Florida officials sued the federal government over President Barack Obama’s healthcare overhaul law. In its original form, the amendment included phrases like, “ensuring against mandates that don’t work”, “protecting the doctor/patient relationship”, and “ensuring access to healthcare without waiting lists.” But Florida judges said “no” to that language and booted the amendment from the ballot. The move sent the proposals crafters—in this case the Florida legislature-- back to the drawing board.

“This Amendment is simply about Healthcare freedom. Making sure that you the individual, the citizen of the state of Florida, has the power to choose the doctor of your choice,” said outgoing Senate President Mike Haridopolos, who helped lead the effort to put the revised version of the amendment back on the November ballot. But when it comes right down to it, the proposal may not do much of anything.

“First of all, it’s important to understand that under the United States Constitution, the federal constitution is the law of the land,” said Marshall Kapp, Director of the Center for Innovative Collaboration in Medicine & Law and Professor of Medicine and Law at Florida State University.

Earlier in the year the U.S. Supreme Court upheld the healthcare overhaul law, including requirements that people purchase health insurance or pay a fine. But the court ruled that other parts of the law—such as expanding the Medicaid program for low income people were optional for states. Kapp says the amendment wouldn’t it block the state from implementing the optional parts of the healthcare law. So, what exactly does this amendment do?

“The only thing I would see in this amendment is, as I say, if the state said we as the state will be the health insurer for all of our citizens such that, no more private insurance…then this amendment, yes, will come into play,” he said. 

The amendment blocks future state legislatures from creating what’s commonly called single-payer or “universal healthcare”. In a system like this, the government pays the medical bills for everyone, and there is no private health insurance market. Should congress ever decide to go single-payer—that would be the law of the land. But if the state tried to enact such a thing, Amendment One would prohibit it.

“It would apply to the state of Florida exclusively. We don’t pretend that we’re Washington D.C. But it’s important that Floridians have a say on the future of their healthcare,” said Senate President Mike Haridopolos. “A lot of people are very concerned about what’s known as ObamaCare. Because not only is it an expensive program, but people are concerned about losing the ability to pick the doctor of their choice, even if their spending their own money for that program.”   

And the probability that Florida’s Republican-dominated legislature would try to enact a single-payer system is extremely low because Republicans largely oppose it.  But if Amendment One passes, and any future legislatures tried to move in that direction, they wouldn’t be able to go very far.