Supporters of Proposition 106 say the law isn't simply a response to federal healthcare reform President Obama signed earlier this year.
"The genesis of this is not some big anti-Obama effort," said Dr. Eric Novack, the Phoenix orthopedic surgeon behind the November ballot initiative.
In fact, Novack said, he's been working on similar initiatives since 2006, long before anyone outside of Chicago even heard of Barack Obama.
The proposition, on Arizona ballots in November, would enshrine in the state constitution the right to pay out-of-pocket for medical services. The law also would ensure Arizonans the right to not purchase health insurance and not be compelled by law to do so.
"It's critically important," Novack said. "If a healthcare service is legal, nobody, not the government or private company bureaucrats, can ever be able to tell you that you can't have access to healthcare services."
The doctor said he wants healthcare decisions to remain in the hands of patients and doctors, not in the clutches of regulators.
A similar reform effort failed by less than 10,000 votes in 2008. Novack said he and his supporters have learned since then. Back then, the proposal was short and vague, a few scant sentences. Although still short by ballot measure standards at about one page, this time around Proposition 106 has more detail.
"We took the criticisms of our opponents to heart," Novack said.
While Novack says the proposal isn't a reaction to national healthcare reforms, many supporters see it as exactly that.
"This is your first stance — your first line of defense — that the federal government cannot force you to buy any healthcare insurance," Dr. Elizabeth Vliet told about 30 attendees at a Pima County Tea Party Patriots event in Oro Valley last week.
Vliet, a Tucson-based women's health specialist, warned attendees of the future troubles she foresees with the implementation of the Affordable Care Act, better known by the pejorative Obamacare.
Sharing tales about wait lists and rationed medical care in the United Kingdom's National Health Service and its Canadian equivalent, Vliet said healthcare reforms passed in the U.S. would put this country in a similar position.
"When the government pays, they get to decide what you get, that's the dilemma," Vliet said.
In addition to concerns that government actuaries would determine what care is appropriate for patients based on age and risk factors and the fear of forced participation, Vliet said the government would interfere with patient-doctor relationships.
"That's why I have said that this is a massive assault on your privacy and liberty," she said. "I think we're headed to the medical gulag."
Proponents of the ballot measure want to use it as a bulwark against what they say will be an onslaught of federal regulations, in particular the mandate that all Americans purchase healthcare insurance either through their employers or in the marketplace. National reforms, which depend upon nationwide participation, impose fines on individuals who do not purchase healthcare insurance.
Opponents of the proposition insist the constitutional change would do little for Arizonans beside rack up legal costs.
"The drafters of Proposition 106 have fundamental misunderstanding of how federal and state laws work," said Arizona House Democrat Kyrsten Sinema.
The Phoenix-area legislator said the initiative would blatantly conflict with the supremacy clause of the Constitution, which holds that federal laws trump conflicting state laws.
"If passed, it would lead to instantaneous lawsuits," Sinema said, adding the effort amounts to a "costly waste of time."
She points out that two lawsuits emanating from the state already have been filed challenging the national healthcare reforms.
Sinema suggested that better efforts could be made at lobbying federal lawmakers to improve the law.
"What they should be doing is working for ways to implement the law to fit Arizonans' need," she said.
In written commentary, Sinema has said Prop 106 would perpetuate a system where insurance companies can cast out people who get sick, or preclude others from coverage who have pre-existing conditions.
But Novack disagrees.
"It's so patently untrue," he said. "All we're saying is you can't be forced to participate if you don't want to."
Novack points out language in the proposition that says it would not affect any law on books as of Jan. 1, 2009. The proposal also would not affect any healthcare services currently allowed under state law.
Something both sides agree on, however, is the anticipated response from the federal government.
"Clearly, this will precipitate a federal court battle that probably will end up in the Supreme Court," Novack said.
Unlike Sinema, however, Novack seems confident in the chance the law would be upheld. He said the courts have no precedence to fall back on because the national government never before has sought to invalidate a freedom enshrined in a state constitution.
Voters will decide the issue on Nov. 2. For additional information on the effort to pass Prop 106, visit www.azhealthcarefreedom.com. Opponents of the proposal have a website at www.prop106endangersyourhealth.org.