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Published Sep. 14, 2009

PHOENIX - Republicans in more than a dozen states opposed to President Barack Obama's push for health care overhaul have mounted state-driven efforts to block federal intervention in health care, with some early success.

In some areas the push-back centers on fact - Obama's stated determination that all Americans should be required to get health care coverage, for example. Other resistance, though, is based on unfounded notions of what has been proposed - fears, for example, that the nation would adopt a single-payer system in which the government would take over health care, something Obama specifically disavowed on Wednesday.

Even if state lawmakers succeed, doubts remain over whether their proposals would take effect if a federal overhaul were passed. Experts say federal law likely would trump such state changes.

"My sense is that if they pass a comprehensive reform bill, it would probably pre-empt what the state is doing," said Paul Bender, a professor at Arizona State University's law school and an expert in constitutional law.

In any case, supporters aren't letting up.

"It became very clear that the direction for what they call health care reform at the federal level was putting at risk our health care freedoms, and we need to move quickly to make sure citizens are protected," said Republican state Rep. Nancy Barto, sponsor of a measure in Arizona.

Lawmakers in eight states, only half of which are controlled entirely by Republicans, have filed proposals this year to ask voters to amend state constitutions to prohibit what they bill as restrictions on a person's freedom to choose a private health care plan, mandatory participation in any given plan and penalties for declining coverage. Similar measures were considered in two other states, though they wouldn't have been decided by voters. And lawmakers in three other states say they plan to file similar ballot proposals in the coming months.

Last week, Minnesota Gov. Tim Pawlenty, a potential 2012 GOP presidential candidate, said that federal health care proposals will step on states' rights and there needs to be a discussion about whether aspects of it are constitutional.

"The larger issue and the more important issue is for state policymakers to remind the federal government that there is a proper role for states, there is a proper role for the federal government and we should be mindful of those boundaries," he said.

As far as ballot initiatives, Arizona is the only state so far to put the proposal on the 2010 ballot.

The Arizona measure began to take root more than three years ago, when Republicans still controlled Congress and a health care overhaul was far from imminent.

Supporters say they weren't trying to cure all weaknesses in the health care system and instead were attempting to keep it from getting worse. They say consumers shouldn't be forced to accept restrictions that could come in a government-run health insurance option.

Opponents say the state measures amount to a defense of a failed and inequitable health care system.

"The idea that they want to put in our Constitution a roadblock to coverage is silly," said state Sen. Dan Gelber, D-Miami Beach. "We have to find ways to cover more people."

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Actions by states over federal plan

Arizona: A grass roots state health care proposal was rejected by voters in November but it failed by less than a half percent.

North Dakota, Wyoming: Measures were voted down in the Republican-controlled Legislatures.

Michigan and Minnesota: No action has been taken on pending proposals.

New Mexico: A proposal never made it out of its first committee before the Democratic-controlled Legislature.

Ohio: A proposal introduced last month awaits action.

Florida: Lawmakers will consider it when they reconvene in the spring.

Indiana: The Senate forwarded to Washington a nonbinding message urging protections of individual health care freedoms.

West Virginia: A binding proposal didn't win approval before the legislative session concluded.

Kansas, Louisiana and Georgia: Lawmakerssay they plan to file ballot proposals in the future.