But there’s little evidence the measure, written before the Supreme Court’s ruling on health care, would do more than send a message, legal and policy experts say.
“Federal law has supremacy over state law,” said Timothy Jost, a law professor at Washington and Lee University who studies health care issues.
Amendment 6 on the November ballot would change the Alabama Constitution of 1901 to state that “a rule or law shall not compel … any person, employer or health care provider to participate in any health care system.”
The amendment sailed through both houses of the Alabama Legislature in 2011, when a new Republican majority — the first in 136 years — was working its way down a long GOP wish list. Supporters of the amendment saw it as a chance to reject the federal Affordable Care Act, popularly known as Obamacare.
“I went to Europe last year, and I heard horror story after horror story about the health care they have there,” said state Rep. Jim Patterson, R-Madison, one of the House sponsors of the amendment.
Patterson said the amendment would block a mandate within the Affordable Care Act that requires people to buy health insurance or else pay a fine. Patterson sees the mandate as the first step toward European-style health care — and he doesn’t mean that as a compliment.
“We’re headed in a European direction,” he said. “We’re not far behind Greece and Italy, with all the problems they’ve been having.”
Alabama’s proposed amendment isn’t the first challenge to the health care law. A collection of states challenged the law in federal court soon after it was passed. In June, the U.S. Supreme Court upheld most of the law, including the insurance-buying mandate.
Now, even advocates of the Alabama amendment aren’t sure it will actually block the health care law.
“It all depends on whether Obama gets re-elected and you get 50 Senate seats,” Patterson said.
Jost, the law professor, is more certain about the amendment’s effect — or lack of effect.
“If somebody in Alabama wants to make a stand in the schoolhouse door, they can,” he said. “But the federal law is what matters. We settled that in 1789.”
A number of states have passed similar measures, Jost said. In the wake of the Supreme Court ruling, he said, none of them limit the mandates of the Affordable Care Act, though they’d likely still prohibit the states themselves from mandating that people buy health insurance.
“If your state wanted to adopt the Romney plan, I suppose the amendment would prevent it,” Jost said. He said it also might affect universities that demand students buy health care — though under the Affordable Care Act, many college-age adults are already covered under their parents’ insurance.
Richard Cauchi, a health care analyst for the National Conference of State Legislatures, said five states have similar measures on the ballot in November.
But they’re latecomers to the game. According to an NCSL analysis, 20 states have already passed some sort measure against the Affordable Care Act.
NCSL hasn’t taken a position on those state measures, Cauchi said. He said it wasn’t clear what effect those measures would have in the wake of the Supreme Court ruling.
“It’s difficult to tell,” he said.
The amendment is a near word-for-word replica of an Arizona amendment passed in 2010. That amendment, Cauchi said, was written before the Affordable Care Act was passed.
Both amendments were written at the Goldwater Institute, a conservative Arizona think tank, said Lucy Caldwell, a spokeswoman for the institute. Asked whether the amendment still had force after the Supreme Court decision, Caldwell said “it’s not really clear if it would block the implementation of the act.”
She said the amendment could still block states from implementing state-level requirements to buy insurance.
Alabama’s constitution, the longest state constitution in the nation, is littered with wording that has already been rejected by the Supreme Court or superseded by federal law. Three amendments on the Nov. 6 ballot would clear out some of that wording, including outdated passages mandating school segregation.
Constitutional reform advocates say they aren’t sure whether Amendment 6 will be dead on arrival.
“I’ve steered clear of the new amendments and focused on constitutional revision,” said former Gov. Albert Brewer, chairman of the Constitutional Revision Commission, established by the Legislature to rewrite the constitution of 1901 article by article.
Lenora Pate, chairwoman of Alabama Citizens for Constitutional Reform, said the organization hadn’t taken a position on the health care amendment. Pate said the large number of amendments on the ballot — 11 statewide measures — could turn off voters to any of the ballot measures.
“I suspect that a lot of people won’t vote on it, or won’t read it and will just vote against it,” she said.
State Rep. Barbara Boyd, D-Anniston, said she voted against the amendment in the Legislature and will do it again Nov. 6.
She said she doesn’t want to do anything to stand in the way of a law that could help a state where many residents live in poverty and don’t have access to health care.
“It’s my belief that the Affordable Care Act will open the door for people who are suffering from health care disparities,” she said. “And because of the makeup of my district, and the makeup of Alabama, I feel it will do us good.”
Capitol & statewide correspondent: 256-294-4193. On Twitter @TLockette_Star.