Politicking began in Tucson on Thursday for a general election ballot proposition that backers tout as protecting individuals from mandates in the new federal health-care law.
About 100 people gathered at Sahuaro High School, many of them leaving with orange-and-blue "Yes on 106" yard signs and promising to spread the word: Government bureaucrats will not control their health.
Pima County is crucial to backers of Proposition 106, who lost a similar measure in 2008 largely because of broad voter opposition in Southern Arizona.
Critics say the proposition will put confusing and dangerous language into Arizona's constitution and that it will prevent future Legislatures from passing laws to guarantee quality health care for all Arizonans, not just those able to purchase care.
Proposition 106 - the Arizona Health Care Freedom Act - would change the state constitution, "to preserve the freedom of Arizonans to provide for their health care," supporters said.
Its language says no law can force someone to participate in any specific health-care program. For supporters of the measure, it means not paying fines the new health-care law mandates for those who don't have health insurance.
"The government may not force you to buy insurance against your will," Dr. Eric Novack told the audience.
Many applauded. "If a health-care service is legal, no one can tell you you can't spend your own money to get it."
Supporters don't want universal health coverage. They also don't want bureaucrats having more power to dictate physician choices and treatment options than the insurance companies and HMOs already wield.
Novack, an orthopedic surgeon from Glendale, is a national leader in a movement that's seeing similar measures being proposed and in some cases passed in other states.
While the Arizona measure certainly takes aim at the federal health overhaul, it was not drafted as a reaction to it, said Novack, who began promoting the concept in 2006.
"This is not a big, broad attempt to take on Obamacare," he said. "It's saying people should simply be able to spend their own money."
Whether or not Arizona Prop. 106 could even hold up as law remains unanswered - critics say federal law supersedes state law anyway. For that reason some critics, among them Rep. Kyrsten Sinema, D-Phoenix, have called the measure a waste of time.
"I'm here because I don't want the federal government telling me I have to buy health insurance," said Christi Brown, 43, who works in the health-care industry and attended Thursday's event.
"I don't want federal intrusion in our private lives," said small-business owner Linda Wood, who's in her 50s. "This (106) stops that."
The Legislature voted to put Prop. 106 on the Nov. 2. general election ballot. It is similar to a ballot initiative from 2008 - then called Prop. 101, which failed by a narrow margin.
Among criticisms two years ago was that Prop. 101's language was so broad that it had the potential of unintended financial consequences for the Arizona Health Care Cost Containment System, AHCCCS, which is Arizona's form of Medicaid.
That year, AHCCCS officials publicly opposed Prop. 101, saying the language prohibiting government from restricting a person's choice of private health-care systems could have been interpreted by a judge to include private contractors used by AHCCCS.
This time around, the proposition's language has been reworded in a way that protects AHCCCS from being affected, agency spokeswoman Monica Coury said Thursday.
"With that in mind, we are neutral," Coury said.
Critics of Prop. 106 include the Arizona AFL-CIO, the Arizona Coalition for a State and National Health Plan, the Arizona AARP, the Arizona chapter of Physicians for a National Health Plan, and Tucson pediatrician Dr. Eve Shapiro, a longtime advocate of health-care reform.
"I'm not sure how the language changed specifically to make AHCCCS not as concerned. But other than that, there are very minor changes (from two years ago)," Shapiro said. "Basically it's the same proposition voters already rejected. It's a constitutional amendment and we don't know what the unintended consequences will be. What's good for public health may well be prevented by this proposition."
Many say if passed, it will end up in court.
State Rep. Phil Lopes, a Tucson Democrat, asked several questions at Thursday's event but said it was difficult to discuss the issue in a balanced way at the event. He's hoping Novack will return to Pima County for a debate on the measure. Novack said he'd consider it.
Tucsonan Jim Hannley, 58, and self-employed, said he's spending $150 per month on a health insurance plan that has a $10,000 deductible. He's counting on federal health reform to give him a more cost-effective plan and asked Novack how Prop. 106 would improve on that.
Novack said the No. 1 problem in health care is that it's too expensive. He said federal health reform will create more expensive bureaucracy, and that Prop. 106 will ensure people will be able to choose the kind of health care they get.
"I thought his answer was vague," Hannley later said.
The Congressional Budget Office this month issued a letter saying that while the federal health-care law could "reduce the projected U.S. budget deficit by $30 billion over the next 10 years," repealing it would increase the deficit by an estimated $455 billion.
Contact reporter Stephanie Innes at firstname.lastname@example.org or 573-4134.