Health Care and Obligations of Citizenship

As the national debate on health care continues in Washington, DC, several states across the Nation are taking steps to protect themselves and their citizens in their state constitutions. Missouri is one of those states. This week a public hearing was held on House Joint Resolutions 48, 50, and 57 which are essential in securing the rights of patients to make their own health care choices.

Even before the events in Washington, DC, the question of patient rights has been bubbling to the surface as an issue important to those interested in keeping the relationship between patient and doctor in tact.

The essence of the proposed constitutional amendment is this, “To preserve the freedom of citizens of this state to provide for their health care, no law or rule shall compel, directly or indirectly or through penalties or fines, any person, employer, or health care provider to participate in any health care system.”

The proposed amendment ensures that:

· Each Missouri citizen has the right to pay for health care services with their own money,

· Health care providers may accept direct payment for services rendered by Missouri citizens,

· The purchase and sale of health insurance shall not be prohibited by law or rule, and;

· No person will be required to pay fines or penalties if they choose to purchase their own health care and accept payment for providing health care services.

In other words, an individual cannot be forced to participate in a health care system without their consent and that individuals have the freedom to participate.

Think about it, there are two general obligations for citizenship in America: paying taxes and the draft. Proposals in Congress today would add a third obligation of forcing each American to purchase health insurance. Never before has the federal government used the force of the federal government to compel every citizen to purchase a product or service.

We can have the debate about whether it is responsible for someone to go without health insurance, but that is a completely different conversation than saying that every citizen must, by the force of law, purchase health insurance or enroll in a government program thereby binding them to the will of faceless bureaucrats.

Some argue that such an amendment to a state constitution is unconstitutional. They argue that the supremacy clause of the US Constitution trumps state actions. It is time that we consider another constitutional principle, that of federalism. As a constitutional principle, it is important not only to the appropriate division of powers between the federal government and the states, but also the ever important pursuit of individual liberty and limited government.

Traditionally, states have been considered laboratories of democracy and innovation. The states were able, even expected, to develop policies reflecting the widely varying local conditions of our great land, and that is especially important in health care. Today, the federal government is asserting, if not amassing, it’s authority over the American life in regards to health care, imposing a "one size fits all" policy. Now is the time to reassert the proper constitutional role of federalism so that future power grabs become more difficult and less likely.

We should allow the people of Missouri to vote on this proposed amendment, allow us to voice our belief in liberty, allow us to direct the future of our state, allow us to direct the future of health care, allow us to retain the freedom that we already enjoy. If a constitutional challenge arises, then let’s have that discussion, but let us not be intimidated into silence and inaction with threat of litigation.

Federalism is all about keeping government within the reach of the people, about keeping government in its place. Health care is personal, it is about us, each of us, and we deserve our rightful place in making health care decisions. The Health Care Freedom Act which I have sponsored keeps government in its place. As Alexander Hamilton proclaimed before the New York ratifying convention, “Here, sir, the people govern.”

House and Senate Priorities

The second week of the session has concluded and business in the Missouri House is taking shape. As bills begin to be referred to committees and committees begin public hearings, the legislative agenda takes shape.

The most notable event of the week occurred on Wednesday when visitors from across the state crowded into the Capitol Rotunda to hold the first ever Missouri State Sovereignty Rally. The purpose of this year’s rally was prompted by the massive opposition by Americans to the federal health care proposals and encroachment of the federal government into our private lives.

Those in attendance are concerned that the federal health care proposals would create an unfair tax on individuals who do not purchase health insurance and penalize businesses that do not offer it to their employees. They oppose the massive expansion of welfare at the expense of the states and lack of fiscal restraint. Their opposition is well founded after Democrat negotiators in Washington caved and exempted union health care plans from their proposed 40% tax creating yet another special class of Americans at the expense of the rest of us.

The week was also the scene of a joint press conference by House and Senate leaders outlining a joint set of priorities for this session. First, and foremost, fiscal responsibility and passing a balanced budget will be front and center. Missouri’s revenue collections continue to lag projections and difficult choices will be in store. The fiscal priorities include:

• Urging Governor Nixon to issue prompt income tax refunds;
• Require legislative oversight for the spending of federal stimulus dollars;
• Reduce fraud and abuse in the Medicaid system
• That the state of Missouri will live within its means; and
• Pledge that there will be absolutely no tax increases on Missourians.

In addition to passing a sound, fiscally responsible state budget so that Missouri continues to be solvent and viable for future generations, these priorities also include protecting our constitutional rights and Liberty; continuing to secure the health, safety, and welfare of all Missourians; and continuing to uphold traditional, common sense Missouri values. Specifically, the House and Senate recognize these issues as necessary to reach these goals:

• Ensure greater transparency and strengthen ethics in government;
• Oppose a bloated and expanded government, support smaller government;
• Oppose the federal government takeover of our health care system;
• Call upon Congress to oppose job destroying cap-and-trade legislation;
• Make certain that statutes pertaining to clean water are implemented to ensure public safety of our citizens; and
• Require credit agencies to withhold reporting negative information if it is caused by identity theft.

As our state continues to face budget uncertainty and Missouri’s unemployment recently inched up to 9.6%, Missouri must be wary of any proposal, state or federal, that would potentially cost Missouri financially or at the expense of our collective identify as Missourians.

These proposals are intended to allow people keep more of their own money, to allow them to make decisions for themselves and their families, to give individuals more liberty in their consumption, savings, and debt retirement. At some point, we, as Americans, will decide whether Thomas Jefferson’s maxim will prevail - will we allow Liberty to yield and government to gain ground?

Crunch Time

With just two weeks left in the First Regular Session of the 95^th General Assembly most of the priorities passed by the Missouri House of Representatives remain lingering or stalled in the Missouri Senate.  At this time, the Missouri House of Representatives and the Missouri Senate have Republican majorities.

This session the House has identified a number of priority issues and passed the bills that express the intent of those priorities.  These priorities include:

• Drug testing for recipients of Temporary Assistance for Needy Families (TANF)
• Adjust income tax brackets to give tax relief to middle class
• Eliminate the franchise tax on small businesses
• Expansion of the Castle Doctrine and the Business Premises Safety Act
• Economic development
• Four-day school week
• Prohibit illegal aliens from enrolling in higher education
• Independence Day Sales Tax Holiday
• Declare Missouri sovereignty under the 10^th Amendment
• Judicial reform
• Guarantee the right to pray in public places
• Create the crime of coercing an abortion
• Tax Payer Bill of Rights
• The Fair Tax

These bills have been passed by the House and are now in the Missouri Senate.  With the exception of the economic development bill, none of the other bills have been passed out of Senate committees and are not available for debate by the Missouri Senate, much less have the opportunity for the Missouri Senate to vote on these bills and get them to the Governor’s desk.

This legislative agenda addresses the interests and needs of Missouri families.  This agenda puts Missouri on the path to prosperity from reductions to the state income tax liability for Missouri families, reducing the tax burden of our small businesses, and improving our economic development toolkit to assist qualifying businesses to stay and locate in Missouri preserving and creating family supporting jobs. 

This agenda preserves our constitutional rights relating to public prayer to the protection and preservation of our 2^nd Amendment rights to asserting our state sovereignty under the 10^th Amendment.

The Missouri House believes taxpayers should be protected from the false philanthropy of bureaucrats and politicians with the taxpayer bill of rights and reforming our tax code to reward saving and individual industry while promoting tax simplification through the fair tax.

With two weeks left and the lack movement by the Missouri Senate on these issues time is running out.  Next week will be consumed with finalizing the state budget for the next fiscal year which must be completed by the constitutional deadline of 6pm on Friday, May 8.  After that the General Assembly must adjourn for the year by the constitutional deadline of 6pm on Friday, May 15.

It is now crunch time.  No bill should be considered dead until the gavel falls on May 15, but these bills must be passed out of committee and put on the Senate calendar to have any chance for debate and passage. 

Committees at Work

This time of year in the Missouri House one finds most of the work being accomplished in committees. It during this time that bills are heard by a small group legislators who review the bill in detail, discuss it’s merits, make amendments, and hear testimony from the public. The hearing process is the time when the public has the opportunity to be on record “for” or “against” any bill before the House or Senate. Hearing schedules can be grueling with most legislators sitting on three to five committees that meet at least once a week for hours at a time.

Once a bill has been vetted in committee and voted “DO PASS” it may advance to the House calendar for debate before the entire body. At this time, few bills sit on the House calendar. That number will increase significantly over the next two to three weeks, when the time demands will shift from committee work to floor debate.

This past week the House Committee on Homeland Security passed a concurrent resolution that aims to protect Missourians from the dangers associated with the closing of Guantonamo Bay as ordered by President Obama. The destination of these suspected terrorists is still in question. This resolution would oppose the use of Missouri’s airports, highways, railways, and waterways for the transportation of these terror suspects. It also would express opposition to the sheltering of these terror suspects in our state as they are being transported to detention centers. Additionally, the resolution opposes granting these prisoners asylum in Missouri. The Missouri House is committed to keeping terror suspects out of our state.

Once again this session, the House passed the Teacher Protection Act, to change the laws regarding school employee liability, safety practices, and reporting acts of violence. It gives teachers the ability to maintain order as long as they follow established school policy. Most importantly, the bill allows school employees to focus on teaching without worrying about litigation.

In addition, the bill makes aware to all teachers and administrators of acts of violence throughout the school. Suspended students would not be allowed on school property without specific permission and would be prohibited from attending off campus, school sponsored activities. It requires a notice of reportable offenses to be attached to an offending student's record and transcript.

The Teacher Protect Act exempts unqualified employees who refuse to administer medication or medical services from disciplinary action and exempts qualified employees from any civil liability for administering medication or medical services. Teachers should be able to take the necessary steps to protect their student’s health.

All of these provisions are aimed at ensuring a safe learning environment for Missouri students.

Also, this week the Real ID and Personal Privacy Committee passed the concurrent resolution that claims sovereignty for the states under the Tenth Amendment of the United States Constitution for all powers not otherwise enumerated and granted to the federal government under the Constitution.

In other news, Congress passed and President Obama signed into law the controversial federal dependency package. This $787 billion dollar package is the largest amount of tax dollars ever spent at one time by Washington. It is unfortunate that we have elected leadership in Washington that has decided to play on America’s financial insecurity to create evermore dependence on the federal government.

From what little that has been communicated to the state, a quick look at, as Senator Chuck Schumer described, the “porky” bill shows us that out of the $787 billion dollar package, $509 billion of our money will be used to expand and grow federal and state welfare programs, create temporary government project jobs that will not receive the same funding in future years, and gives tax cuts to people who don’t pay income taxes, in other words, it redistributes wealth.

Now that the bill has passed, Governor Nixon and the Missouri General Assembly have significant decisions to make. Missouri is expected to receive about $4.3 billion from this package. Our total state budget is about $22 billion, so this federal give-away is equivalent to increasing our spending by nearly 20%. Washington’s ways cannot be Missouri’s ways. The Missouri House is committed to using one-time dollars for one-time expenditures. We refuse to put ourselves in a position to spend money today that we will likely not have in the future.

Enumerated vs. Reserved Powers

Federalism isn’t something that we here much about these days. That’s too bad, because it is federalism that allows us to govern ourselves at the state level while retaining the protections of a federal government. It ensures that “We the People” have the greatest latitude in determining our own destinies by retaining our state sovereignty while constitutionally sharing power with our federal government in Washington, DC.

The relationship between state governments and the federal government has been evolving since the adoption of the Constitution of the United States. Unfortunately, this evolution has resulted in less Liberty and more centralized government.

The Constitution sets out in Article I, Section 8 a list of enumerated powers that include such powers as the right to levy taxes, declare war, regulate interstate and foreign commerce, coin money which they are doing a lot of these days, and borrow money on the credit of the United States which they are also doing a lot of these days to name a few.

Those powers not delegated to the federal government are reserved to the people or the states. It is here that states like ours have the ability to govern ourselves in such a fashion that suits our specifics needs. It is also here where conflict occurs.

The Necessary and Proper Clause in Article I, Section 8 gives the federal government an implied power to pass any law “necessary and proper” for the execution of the enumerated powers. While on the surface this appears to restrict Congress from meddling in the affairs of the states, it has been used to usurp the authority of the states time and time again.

Recent usurpations have included everything from the No Child Left Behind Act to the Health Insurance Portability and Accountability Act. They manifest themselves as unfunded mandates from the federal government to the state and local governments, especially in welfare, education, and environmental programs.

Other violations occur when state and local governments look to the largesse of the federal coffers to subsidize local initiatives and programs. These federal dollars always come with strings attached which entangle state and federal officials in a Gordian knot of unfunded mandates and unjustifiable subsidies leaving taxpayers with more debt and less Liberty – in other words, beware of the federal dependency package being fast tracked through Congress.

The Missouri House is considering a resolution to be sent to the President and Congress reminding them that Missouri has read the Constitution and affirms our 10th Amendment rights. We wish to serve as Notice and Demand to the federal government, as our agent, to cease and desist, effective immediately, mandates that are beyond the scope of the constitutionally delegated powers and that all compulsory federal legislation which directs states to comply under threat of civil or criminal penalties or sanctions or requires states to pass legislation or lose federal funding be prohibited or repealed.

In other words, unshackle us.

In a similar move the Missouri House passed a resolution which strongly opposes any enactment of the federal Freedom of Choice Act (FOCA). FOCA undermines the right and responsibility of the states and the people to debate, vote on, and determine abortion policy. The protection of women's health through state regulation on abortion is a state interest that should not be abolished by Congress. If this legislation was passed by Congress and signed into law it would overthrow numerous commonsense protective laws properly enacted by Missouri including the ban on partial birth abortions.

Our Founding Fathers understood that state governments possess inherent advantages in the governance of our home concerns whether they are education, health care, transportation, business regulation within our state’s borders, agriculture, corrections, and even the management of our fish and wildlife.

Traditionally, states have been considered laboratories of democracy. The states were able, even expected, to develop policies reflecting the widely varying local conditions of our great land. Today, the federal government is asserting, if not amassing, it’s authority over the full range American life, imposing a "one size fits all" policy. Now is the time to reassert the proper constitutional role of federalism so that future power grabs become more difficult and less likely.

The federal government must be reminded, in Alexander Hamilton’s words that, “Here, sir, the people govern.”