Todd Akin’s official response to the health care reform victory is, as one might expect, shrill in the extreme. He has managed to jam almost every GOP screaming point into a few short paragraphs. Since the event that occasioned this vitriolic outburst is the passage of  what is actually very moderate legislation, it might be instructive to deconstruct his florid imagery in order to figure out what Republican rage is really all about:

“Today Americans are reacquainted with the danger of an arrogant all powerful government, a deadly enemy within, a clear and present danger in Washington.”

“Americans” in this context refers to Tea Partiers and corporations. “Arrogance” refers to the fact that the Democratic congress defied corporate initiated Tea Party tantrums and inept Republican legislative tactics in order to help the president fulfill one of the campaign promises that got him elected. “All powerful government” refers only to elected Democrats; when Republicans lie in order to force-march the country into deficit-busting wars, they are patriots. “A deadly enemy within” means that these same Democrats threaten a resurgent Republican hegemony, since they pose “a clear and present danger” to the GOP by revealing its sabre rattling to be nothing more than empty noise.

“In spite of nationwide opposition socialized medicine is being forced down our throats. That medicine is toxic to freedom. But freedom dies hard in America.”

Akin considers “nationwide opposition” to be the 43% of the respondents to a  recent CNN poll that disapprove of the health care reform because it is “too liberal” – although, if truth be told, many of those probably only disapprove because they have bought into the Republican misinformation campaign, and will no doubt be pleasantly surprised to find that the passage of Health Care reform has not, in fact, killed Blaine Luetkemeyer’s father. Akin clearly does not consider worthy of consideration the other 52% who approve of the legislation, or who think it is not liberal enough.  

“Socialized medicine” reflects the Republican tendency to characterize as socialism any effort to govern for the good of the people rather than corporations or cronies. Their use of the term reflects their inability to distinguish between (1) social welfare and social justice; and, (2)  the goal of social justice (or social welfare) and the means used to achieve it; hence any legislation that has a stated goal of securing social welfare or social justice is, ipso facto, socialist, communist, or even facist (which explains those pictures of Obama as Hitler, as well as Glenn Beck’s fear of almost all Christians).

“Forced down our throats” (alternatively, the ubiquitous “crammed down our throats”) is Republican speak for the democratic process that has led to health care reform, including the decision to finally ignore Republican obstructionism. The goal of the phrase is to make relatively straightforward and commonplace legislative processes seem far more unpalatable than they really are.

“Freedom” is a fluid concept on the right. It usually means minimal or no taxes –  often without cutting social services fringewingers themselves find useful, although there are a few more sophisticated souls who understand it in the Friedmanesque  sense of untrammeled capitalism, the “nature red in tooth and claw” of the Social Darwinists revisited, this time from a macroeconomic rather than a biological perspective. In this sense, Akin is correct that “freedom dies hard in America.” The nasty, obstructionist mess that the GOP helped orchestrate during the past year bears witness to the fact that this type of ersatz “freedom” is indeed resilient, especially when liberally fertilized with money from health care industries that really, really love the freedom to run roughshod over the rest of us.*

“I do not believe that the majority of Americans will submit passively to the gold chains of socialism.” True patriots choose the bright light and fresh air of freedom where people can dare to dream- to succeed or fail.”

In this exhortation to action, Akin is calling for the Tea Party dupes to continue with their rabid displays in order to give him cover as he continues to work against their and our best interests. To create the emotional tenor that gets these babies revving their engines, he sets up an opposition in which health care reform is equated with passivity and slavery, while the advocates of unregulated market “freedom” and their corporate beneficiaries, the very folks responsible for our broken health care delivery system, are associated with words like “patriot,” “bright light,” “fresh air,” and the fulfillment of striving.

“I have confidence that freedom will rise from the ashes of socialism and that this nation under God will have a rebirth of liberty and a government of the people, by the people and for the people.”

In this final trope Akin brings into play themes that will recur as Republicans attempt to use health care legislation as a lever to undo Democrats in the next election. In one grand, if rather derivative swoop, he dresses anti-health care forces in both Godly and constitutional garb. Sadly, substituting rhetoric for reasoned argument does not create a well-fitting garment, but rather one that will have to be discarded sooner or later.

Akin’s agitprop language is far from original. The words may differ slightly, “totalitarian” substituted for “socialistic,” for example, but most members of the Grand Old Party are expressing nearly identical sentiments. The Republican obstructionist message serves the same goal: getting the GOP back into power. Representative Jo Ann Emerson said it far more succinctly than Akin when she helped egg on the Tea Party thugs over the weekend, joining three other Gopers  on a balcony waving  signs reading “Kill” “The” “Bill.”  What she was really saying, of course, is “I’ll do anything, no matter how depraved, to stay in Washington.”

*The text of this sentence has been edited slightly.

 

President Barack Obama, Vice President Joe Biden, and senior staff, react in the Roosevelt Room of the White House, as the House passes the health care reform bill, March 21, 2010. (Official White House Photo by Pete Souza)

President Obama’s remarks last night from the East Room after passage of the historic bill:

THE WHITE HOUSE

Office of the Press Secretary

_________________________________________________________________

For Immediate Release                             March 22, 2010

REMARKS BY THE PRESIDENT

ON THE HOUSE VOTE ON HEALTH INSURANCE REFORM

March 21, 2010

East Room

11:47 P.M. EDT

    THE PRESIDENT:  Good evening, everybody.  Tonight, after nearly 100 years of talk and frustration, after decades of trying, and a year of sustained effort and debate, the United States Congress finally declared that America’s workers and America’s families and America’s small businesses deserve the security of knowing that here, in this country, neither illness nor accident should endanger the dreams they’ve worked a lifetime to achieve.

    Tonight, at a time when the pundits said it was no longer possible, we rose above the weight of our politics.  We pushed back on the undue influence of special interests.  We didn’t give in to mistrust or to cynicism or to fear.  Instead, we proved that we are still a people capable of doing big things and tackling our biggest challenges.  We proved that this government — a government of the people and by the people — still works for the people.

     I want to thank every member of Congress who stood up tonight with courage and conviction to make health care reform a reality.  And I know this wasn’t an easy vote for a lot of people.  But it was the right vote.  I want to thank Speaker Nancy Pelosi for her extraordinary leadership, and Majority Leader Steny Hoyer and Majority Whip Jim Clyburn for their commitment to getting the job done.  I want to thank my outstanding Vice President, Joe Biden, and my wonderful Secretary of Health and Human Services, Kathleen Sebelius, for their fantastic work on this issue.  I want to thank the many staffers in Congress, and my own incredible staff in the White House, who have worked tirelessly over the past year with Americans of all walks of life to forge a reform package finally worthy of the people we were sent here to serve.

    Today’s vote answers the dreams of so many who have fought for this reform.  To every unsung American who took the time to sit down and write a letter or type out an e-mail hoping your voice would be heard — it has been heard tonight.  To the untold numbers who knocked on doors and made phone calls, who organized and mobilized out of a firm conviction that change in this country comes not from the top down, but from the bottom up — let me reaffirm that conviction:  This moment is possible because of you.

    Most importantly, today’s vote answers the prayers of every American who has hoped deeply for something to be done about a health care system that works for insurance companies, but not for ordinary people.  For most Americans, this debate has never been about abstractions, the fight between right and left, Republican and Democrat — it’s always been about something far more personal.  It’s about every American who knows the shock of opening an envelope to see that their premiums just shot up again when times are already tough enough.  It’s about every parent who knows the desperation of trying to cover a child with a chronic illness only to be told “no” again and again and again.  It’s about every small business owner forced to choose between insuring employees and staying open for business.  They are why we committed ourselves to this cause.

    Tonight’s vote is not a victory for any one party — it’s a victory for them.  It’s a victory for the American people.  And it’s a victory for common sense.

    Now, it probably goes without saying that tonight’s vote will give rise to a frenzy of instant analysis.  There will be tallies of Washington winners and losers, predictions about what it means for Democrats and Republicans, for my poll numbers, for my administration.  But long after the debate fades away and the prognostication fades away and the dust settles, what will remain standing is not the government-run system some feared, or the status quo that serves the interests of the insurance industry, but a health care system that incorporates ideas from both parties — a system that works better for the American people.

    If you have health insurance, this reform just gave you more control by reining in the worst excesses and abuses of the insurance industry with some of the toughest consumer protections this country has ever known — so that you are actually getting what you pay for.

    If you don’t have insurance, this reform gives you a chance to be a part of a big purchasing pool that will give you choice and competition and cheaper prices for insurance.  And it includes the largest health care tax cut for working families and small businesses in history — so that if you lose your job and you change jobs, start that new business, you’ll finally be able to purchase quality, affordable care and the security and peace of mind that comes with it.

    This reform is the right thing to do for our seniors.  It makes Medicare stronger and more solvent, extending its life by almost a decade.  And it’s the right thing to do for our future.  It will reduce our deficit by more than $100 billion over the next decade, and more than $1 trillion in the decade after that.

    So this isn’t radical reform.  But it is major reform.  This legislation will not fix everything that ails our health care system.  But it moves us decisively in the right direction.  This is what change looks like.

    Now as momentous as this day is, it’s not the end of this journey.  On Tuesday, the Senate will take up revisions to this legislation that the House has embraced, and these are revisions that have strengthened this law and removed provisions that had no place in it.  Some have predicted another siege of parliamentary maneuvering in order to delay adoption of these improvements.  I hope that’s not the case.  It’s time to bring this debate to a close and begin the hard work of implementing this reform properly on behalf of the American people.  This year, and in years to come, we have a solemn responsibility to do it right.

    Nor does this day represent the end of the work that faces our country.  The work of revitalizing our economy goes on.  The work of promoting private sector job creation goes on.  The work of putting American families’ dreams back within reach goes on.  And we march on, with renewed confidence, energized by this victory on their behalf.

    In the end, what this day represents is another stone firmly laid in the foundation of the American Dream.  Tonight, we answered the call of history as so many generations of Americans have before us.  When faced with crisis, we did not shrink from our challenge — we overcame it.  We did not avoid our responsibility — we embraced it.  We did not fear our future — we shaped it.

    Thank you, God bless you, and may God bless the United States of America.

                                         END                 11:55 P.M. EDT

Today, after yesterday’s disgusting incidents initiated by teabaggers, House Speaker Nancy Pelosi (D), holding the 1965 Medicare gavel, and John Lewis (D) marched arm in arm past chanting teabaggers:

Video by Sam Stein.

That’s how you do it. That’s my kind of Speaker.

Congressman Ike Skelton (D – MO)

Apparently, for Congressman Ike Skelton (D), it is.

I just called his Washington office and the nice person on the other end of the phone, in response to my question, “Now that Congressman Stupak is supporting the health care reform bill, will Congressman Skelton vote for it?,” responded, “No…”

Remember this, from 1993?:

…The turning point for Margolies-Mezvinsky came when she made a last-minute switch to support the 1993 Clinton budget after months of publicly voicing her opposition to the bill because it did not contain enough spending cuts. During her campaign, she had promised not to raise taxes, and the budget proposed a hike in federal taxes, including a gasoline tax. On the day of the vote, she appeared on television and told her constituents that she was against the budget. Minutes before the vote, however, on August 5, 1993, President Clinton called to ask Margolies-Mezvinsky to support the measure. She told him that only if it was the deciding vote-in this case, the 218th yea-would she support the measure. “I wasn’t going to do it at 217. I wasn’t going to do it at 219. Only at 218, or I was voting against it,” she recalled. She also extracted a promise from Clinton that if she did have to vote for the budget package, that he would attend a conference in her district dedicated to reducing the budget deficit. He agreed (and later fulfilled the pledge). Nevertheless, Margolies-Mezvinsky told Clinton “I think I’m falling on a political sword on this one.” When she finally walked onto the House Floor to cast the decisive vote, passing the measure 218 to 216, Democrats cheered while Republicans jeered, “Goodbye, Marjorie!” She later recalled that “I knew at the time that changing my vote at the 11th hour may have been tantamount to political suicide…. [but] the vote would resolve itself into one simple question: Was my political future more important than the agenda the President had laid out for America?”…

[emphasis added]

A freshman legislator had to be the deciding vote while long time (and safer) incumbents couldn’t exhibit any political courage.

You know, we elect people to office to make the right decisions, not to be frightened by half truths, opposition distortions, the propaganda arm of the rnc, or crazy people. It’s not supposed to be too much to ask to do the right thing. But, apparently, it is in Missouri.

I expressed my extreme disappointment to that nice person on the other end of the phone.

We received the following statement from Congressman Emanuel Cleaver’s (D-MO) office:

For many of the members of the CBC, like John Lewis and Emanuel Cleaver who worked in the civil rights movement, and for Mr. Frank who has struggled in the cause of equality, this is not the first time they have been spit on during turbulent times.

This afternoon, the Congressman was walking into the Capitol to vote, when one protester spat on him. The Congressman would like to thank the US Capitol Police officer who quickly escorted the others Members and him into the Capitol, and defused the tense situation with professionalism and care. After all the Members were safe, a full report was taken and the matter was handled by the US Capitol Police. The man who spat on the Congressman was arrested, but the Congressman has chosen not to press charges. He has left the matter with the Capitol Police.

This is not the first time the Congressman has been called the “n” word and certainly not the worst assault he has endured in his years fighting for equal rights for all Americans. That being said, he is disappointed that in the 21st century our national discourse has devolved to the point of name calling and spitting. He looks forward to taking a historic vote on health care reform legislation tomorrow, for the residents of the Fifth District of Missouri and for all Americans. He believes deeply that tomorrow’s vote is, in fact, a vote for equality and to secure health care as a right for all. Our nation has a history of struggling each time we expand rights. Today’s protests are no different, but the Congressman believes this is worth fighting for.

Other media reports:

Tea Party Protests: ‘Ni**er,’ ‘Fa**ot’ Shouted At Members Of Congress

Dems: Protests get ugly, racist

Call your members of Congress today.

The health care reform express seems to be underway at last – and Republicans are throwing frothing-at-the-mouth tantrums that seem to include the type of impotent threat that characterize bad losers everywhere. Consider Tom Coburn’s promise:

If you voted no and you vote yes and you lose your election and you think any nomination to a federal position isn’t going to be held in the Senate, I’ve got news for you, it’s going to be held

Not really much of a threat, though, since, as Faiz Shakir of ThinkProgress observes, Coburn is describing a unlikely situation that could only ever affect a small number of people.

Or take the statement released by Indiana’s Dan Burton on the subject of the Republicans’ two failed attempts to stop the process today:

“We didn’t stop it, but now we have their names.  Today, 222 Democrats are on record for supporting the unconstitutional “Slaughter Solution,” which will allow them to pass the Senate health care bill without actually voting on it.

Apart from the hypocritical mischaracterization of the the “deem and pass” maneuver to which he is referring (since is in his fourteenth House term, he has to have supported the “deeming” process that Republicans used 36 times in 2005 and 2006) – I guess he means that his big, bad Republcan gang will make Democrats pay for doing what they are paid to do – watch out for the welfare of the people.

Well, Dan Burton, I’ve got news for you – we can all play at that game. Looking at the roll call, it seems that the members of the Missouri delegation that voted to move things along are Lacy Clay (D-1st); Russ Carnahan (D-3rd) Emanual Cleaver (D-5th). It is worth noting that Ike Skelton (D-4th), although he has indicated that he will not vote for the final bill, joined his fellow Democrats today to allow the process to go ahead – he ought to get some credit for that at least.

It would be great if these reliable Democrats (even, this time, Skelton) got some encouragement. You know what I mean – maybe send some thank you emails, letters or phone calls – or even a little donation, either now or when health care reform, God willing, is a done deal. On the other hand, I am sure nobody would take it amiss if anyone wanted to to send a few coals to the usual suspects in the Party of No: Todd Akin (R-2nd), Roy Blunt (R-7th), Jo Ann Emerson (R-8th), Sam Gravaes (R-6th), and last among the least,  Blaine Luetkemeyer (R-9th).

You don’t suppose that the Washington Post (via HuffPost)suspects there might be a connection between campaign contributions and the votes of House members on the health care bill, do you? Because WaPo has a chart showing the vote of every Rep. on the health care bill in November, his intent on the coming vote, the amount of campaign contributions he’s received from the health care industry and the percentage of his constituents that are uninsured.

If WaPo is of that cynical turn of mind, I have to say that the chart is far from providing proof. For example, the industry gave $81,050 to Emanuel Cleaver. I mean, this is Cleaver we’re talking about. He wouldn’t vote against that health care bill under any less compulsion than a gun to his head. All that contribution shows is that the health care industry has way too much moolah it can afford to squander. And did they seriously think that $201,280 would sway Lacy Clay or that $217,462 might net them Russ Carnahan’s vote? I guess people with excessive profits to throw around and a lot to lose will hedge every bet. There is this to be said about the largess handed out to Missouri Democrats: the least money went to the solidest yes vote and the most money–$250,754 to Ike Skelton–went to the single no vote. (And considering that 16.8 percent of Skelton’s constituents lack insurance, that is one odious vote.)

Contributions on the R side are almost as nonsensical. The industry gave $367,501 to Todd Akin. What for? It’s not like there was a snowball’s chance he’d vote for health care reform. Less than 8 percent of his constituents lack health care, so they approve of him preaching the gospel of independence. And besides, he’s genetically incapable of empathy much less of having enough sense to see that health care premiums will eventually sink this economy. A handshake and a smile would have kept him in the anti-reform camp. Sure, he’d have resented not getting paid off, but he’d have cut his right hand off at the wrist before he’d vote for a socialistic bill.

Predictably, Roy Blunt raked in the most, almost two and a half million–that, despite the fact that almost twenty percent of his constituents lack health care. Let them eat cake. Roy Blunt has one finely honed skill as a congressman: attracting campaign cash. As night follows day, big business money follows Blunt.

Do you suppose Jo Ann Emerson is jealous? She only got a half million, although she has the exact same percentage (19.8) of uninsured constituents as Blunt. If either one of them were going to entertain the notion of voting for reform, it would have been Emerson, not Blunt. So where’s the justice? On the other hand, a half mil isn’t peanuts.

Sam Graves got almost as much as Emerson ($414,399) and Luetkemeyer–because he’s a lowly freshman?–only tallied $61,200. That’s less than Cleaver got. What?

Anyway, like I said, I just don’t see that these numbers prove any intent to corrupt our legislators. The honchos at Wellpoint could claim that the chart is evidence only that they’re not all that bright in how they dispense their contributions. And, they would add, anyone who thinks congressmen got paid for their votes is either too cynical or is living a paranoid fantasy.

Yesterday, from a republican member of the House in the Missouri General Assembly at the opening of debate on HJR 48, 50 & 57 (a republican sponsored state constitutional amendment nullifying federal health care reform legislation):

…Mister Speaker, Democrats now, across the country are rising in support of the “health care freedom acts.” They are speaking out in op, they are speaking out in opposition to the federal plans…Representative, our own Representative Ike Skelton, here in Missouri, voted against the House version of the federal takeover earlier this year. And just today, this morning on the radio Congressman Skelton said, that what they are doing currently in DC on their proposed violations of various Congressional rules is an abomination…

I’m not particularly impressed with a republican legislator attributing inflammatory language on the part of any Democrat in support of a bogus republican agenda. Though, to be clear, Congressman Skelton (D) issued a statement in November explaining why he did not support the health care reform bill.

The House Committee on Energy and Commerce issued a publication today showing Benefits of Health Care Reform, District by District Impact. “The Committee has prepared, for all 435 congressional districts, a district-level analysis of the impact of health care reform legislation. This analysis includes information on the impact of the legislation on families, small businesses, seniors in Medicare, health care providers, and the uninsured.” [you can check out the numbers for each congressional district in the nation]:

March 2010

The Benefits of Health Care Reform

In the 4th Congressional District of Missouri [pdf]

Committee on Energy and Commerce

The U.S. House of Representatives will soon vote on health care reform legislation. This legislation will make health care affordable for the middle class, provide security for seniors, and guarantee access to health insurance for the uninsured – while reducing the federal deficit by over $100 billion over the next decade. This analysis examines the benefits of the legislation in the 4th Congressional District of Missouri, which is represented by Rep. Ike Skelton.

In Rep. Skelton’s district, the health care reform bill will:

• Improve coverage for 390,000 residents with health insurance.

• Give tax credits and other assistance to up to 187,000 families and 14,900 small businesses to help them afford coverage.

• Improve Medicare for 120,000 beneficiaries, including closing the donut hole.

• Extend coverage to 55,500 uninsured residents.

• Guarantee that 11,400 residents with pre-existing conditions can obtain coverage.

• Protect 1,200 families from bankruptcy due to unaffordable health care costs.

• Allow 53,000 young adults to obtain coverage on their parents’ insurance plans.

• Provide millions of dollars in new funding for 13 community health centers.

• Reduce the cost of uncompensated care for hospitals and other health care providers by $74 million annually…

[emphasis in original]

Using the language of a republican member of the Missouri House – 55,000 uninsured individuals in the 4th Congressional District is indeed an abomination.

This morning the Missouri House took up debate on HJR 48, 50 & 57, a state constitutional amendment nullifying federal health care reform legislation.

Our good friends at Fired Up via Twitter:

Uninterested in dealing with actual state issues, MO House turns its attention back to federal legislation…    about 13 hours ago   via DestroyTwitter  

From the beginning:

republican Representative [speaking as an advocate of the resolution at the opening of the debate]: …Democrat  Congressman Bart Stupak, if you’re pro-life you will vote for the health care freedom act and against Obamacare….

Representative Cynthia Davis (r – let them eat McDonalds), debating HJR 48, 50 & 57

There was a flood of something, and it wasn’t water. Representative Cynthia Davis (r – let them eat McDonalds), fifty-five minutes into the debate:

…Representative Cynthia Davis :  Good morning, I rise to speak on the HJR.

Speaker: Proceed, lady.

Representative Cynthia Davis : Thank  you. Mister Speaker, a lot of people are confused about what is the role of the national government and what is the role of the state government. Truth is, the national government has no business doing education or health care. It’s not in the Constitution. You know, a river is a beautiful thing when it stays within its boundaries, but when it’s unlimited it’s called a flood.  And a flood is destructive. And it’s not pretty anymore.  [inaudible] Also, this has nothing to do with Barack Obama. It has to do with choice. It has to do with liberty. And it has to do with our freedom and our right to govern ourselves. The national program really has nothing to do with protecting insurance companies either. You know, I moved here from Massachusetts. And they forced everybody to get on the insurance program and they still have not achieved that goal. And if Massachusetts had such a great plan show me where are the people clamoring to move into Massachusetts? The bigger question I want all of you to consider today is why would any state legislator want to give up our liberty? You know, we’re vested with the duty of protecting our citizens and protecting their liberty is foundational.

Some of you may have not heard my bullying story. When I was in seventh grade I learned a lesson about bullies that I’ll never forget. You know, the national government is strutting around like a big bully. And unless we say no, we’re gonna get hurt. There was a time in junior high when all the classes had to pass in the hallway. There was a girl who, apparently, didn’t like me, though I will never know why. But she would sneak up behind me and stick her foot in front of mine and trip me. So I’d fall or sometimes almost fall. And then I’d go home and I’d tell my mother. Mom, this girl tried to trip me again today.  And my mom said the only way to stop it is if you stand up to her and hold firm. Well there was one day when we were passing through the hall, through the classroom and, and, and I, I noticed her tripping me and, and I turned around and what happened next was a blur.  But, it was good. It was good ’cause I stood up to her and, and the, we were ushered to the principal’s office and the principal called my mom and said, your daughter was engaged in a fight. And my mom was never more proud of me. And that girl never tripped me again.

And that is what we’re confronting with this resolution to try and tell the federal government, you can not bully us, we are gonna stop you right here, right now. We’re gonna protect our citizens.

This HJR is our only and last hope for protecting Missourians, to keep their freedoms and their rights.  Thank you….

“…Also, this has nothing to do with Barack Obama…”

You weren’t listening to your colleague at the start of debate, were you?

“…It has to do with choice…”

So, if you support the resolution you’re pro-choice?

“…And it has to do with our freedom and our right to govern ourselves…”

Question. Didn’t we elect our members of Congress? Just asking. Oh, you meant they should all be republicans just like you.

“….[blah, blah, blah] your daughter was engaged in a fight…”

You’re not advocating violence, are you?

“…our only and last hope…”

Obi-wan would be so proud.

What the House passed and sent to the Senate today:

SECOND REGULAR SESSION

[PERFECTED]

HOUSE COMMITTEE SUBSTITUTE FOR

HOUSE JOINT RESOLUTION NOS. 48, 50 & 57

95TH GENERAL ASSEMBLY

3173L.02P                                                                                                                                                 D. ADAM CRUMBLISS, Chief Clerk

JOINT RESOLUTION

Submitting to the qualified voters of Missouri an amendment to article I of the Constitution of Missouri, relating to prohibiting laws interfering with freedom of choice in health care.

Be it resolved by the House of Representatives, the Senate concurring therein:

           That at the next general election to be held in the state of Missouri, on Tuesday next following the first Monday in November, 2010, or at a special election to be called by the governor for that purpose, there is hereby submitted to the qualified voters of this state, for adoption or rejection, the following amendment to article I of the Constitution of the state of Missouri:

           Section A. Article I, Constitution of Missouri, is amended by adding thereto one new section, to be known as section 35, to read as follows:

           Section 35. 1. That a law or rule shall not compel, directly or indirectly, any person, employer, or health care provider to participate in any health care system.

           2. A person or employer may pay directly for lawful health care services and shall not be required to pay penalties or fines for paying directly for lawful health care services. A health care provider may accept direct payment for lawful health care services and shall not be required to pay penalties or fines for accepting direct payment from a person or employer for lawful health care services.

           3. Subject to reasonable and necessary rules that do not substantially limit a person’s options, the purchase or sale of health insurance in private health care systems shall not be prohibited by law or rule.

           4. This section does not:

           (1) Affect which health care services a health care provider or hospital is required to perform or provide;

           (2) Affect which health care services are permitted by law;

           (3) Prohibit care provided under workers’ compensation as provided under state law;

           (4) Affect laws or regulations in effect as of January 1, 2010;

           (5) Affect the terms or conditions of any health care system to the extent that those terms and conditions do not have the effect of punishing a person or employer for paying directly for lawful health care services or a health care provider or hospital for accepting direct payment from a person or employer for lawful health care services.

           5. As used in this section, the following terms shall mean:

           (1) “Compel”, any penalties or fines;

           (2) “Direct payment or pay directly”, payment for lawful health care services without a public or private third party, not including an employer, paying for any portion of the service;

           (3) “Health care system”, any public or private entity whose function or purpose is the management of, processing of, enrollment of individuals for or payment for, in full or in part, health care services or health care data or health care information for its participants;

           (4) “Lawful health care services”, any health-related service or treatment to the extent that the service or treatment is permitted or not prohibited by law or regulation that may be provided by persons or businesses otherwise permitted to offer such services; and

           (5) “Penalties or fines”, any civil or criminal penalty or fine, tax, salary or wage withholding or surcharge or any named fee with a similar effect established by law or rule by a government established, created or controlled agency that is used to punish or discourage the exercise of rights protected under this section.

           Section B. Pursuant to chapter 116, RSMo, and other applicable constitutional provisions and laws of this state allowing the general assembly to adopt ballot language for the submission of a joint resolution to the voters of this state, the official ballot title of the amendment proposed in section A of this resolution shall be as follows:

           “Shall the Missouri Constitution be amended as follows:

1. That government may neither penalize citizens for refusing to purchase private health insurance, nor infringe upon a citizen’s right to offer or accept direct payment for lawful health care services.

2. This section shall permit courts to enforce contracts voluntarily entered, and the General Assembly to regulate the health insurance industry.”

Here’s hoping the Missouri Senate sits on it.