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Protecting

Our Health Care.

Preserving

Ohioans Freedom.

TABLE OF CONTENTS
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OhiO healthcare FreedOm amendment eFFects OF the OhiO healthcare FreedOm amendment Obamacare and WOmen Obamacare and Families Obamacare and seniOrs Obamacare and dOctOrs Obamacare and business OhiOans FOr healthcare FreedOm disclOsure statement JOin Our team tOday

OhiO healthcare Freedom Amendment


To preserve the freedom of Ohioans to choose their health care and health care coverage

FReqUentlY ASked qUeStionS


Q: Does the Health Care Freedom Amendment override the entire federal health care reform bill?
a: the health care Freedom amendment only addresses the individual mandate component of the health care reform bill. however the individual mandate is the cornerstone of the health care reform bill and if enough states resist the individual mandate the bill is most likely unenforceable.

SUMMARY To add Section 21 to Article I of the Constitution


of the State of Ohio
the prOpOsed amendment WOuld p r O v i d e t h a t:
1. in Ohio, no law or rule shall compel, directly or indirectly, any person, employer, or health care provider to participate in a health care system. 2. in Ohio, no law or rule shall prohibit the purchase or sale of health care or health insurance. 3. in Ohio, no law or rule shall impose a penalty or fine for the sale or purchase of health care or health insurance.

Q: Arent states prohibited from contradicting federal law because federal law is supreme?
a: this is not necessarily true and the courts can go either way on this question. constitutionally the federal government is supreme when it comes to its enumerated powers. in areas such as health care policy, individual states have reserved the right to enact their own reforms. currently most federal regulation is justified under the commerce clause of the us constitution. however, the health care reform bill is the first time the federal government will force all americans to buy a commercial product, making the mere act of being alive an act of commerce.

the prOpOsed l aW WOuld nOt


1. affect laws or rules in effect as of march 19, 2010. those laws include medicare, medicaid, social security disability, veterans programs, and even the recently-enacted prescription drug benefit and schip program. 2. affect which services a health care provider or hospital is required to perform or provide. 3. affect terms and conditions of government employment. 4. affect any laws calculated to deter fraud or punish wrongdoing in the health care industry.

Q: If this amendment passes, will I be able to purchase, in Ohio, health insurance from Blue Cross, for example, if I dont want to participate in the federal pool?
a: Our amendment does nothing to prohibit anyone from purchasing any type of health insurance that they want. the amendment does nothing to limit choice. it is impossible to predict how any particular insurance company would respond to the amendment, but businesses are eager to sell products to those who are willing to buy them.

Q: How do I get more information about the Amendment?


a: For more information, see www.Ohioconstitution.org, or contact maurice a. thompson, director of the 1851 center for constitutional law at (614) 340-9817.

Freedom Amendment
the Ohio health care Freedom amendment, which will appear on the november 2011 ballot, would amend the Ohio constitution by adding section 21 to article i, Ohios bill of rights, to preserve the freedom of Ohioans to choose their health care and health care coverage. it is the intentions of the amendments drafter (the 1851 center for constitutional law) and proponents (Ohioans for health care Freedom, the Ohio project, the Ohio liberty council, and others) that the amendment provide the greatest possible protections against, separately and distinctly, federal, state, and local efforts to preserve and protect Ohioans freedom to make their own health care and health insurance decisions. the following is a summary of the amendments necessary, plausible, and conceivable effects, as well as observations regarding what the amendment does not do.

EffEcts of thE ohio hEalthcarE

Passage of the ohio Health Care Freedom Amendment has the capacity to protect ohioans from the requirements of the Patient Protection and Affordable Care Act.
by placing health care freedom in the Ohio constitutions bill of rights, the Ohio health care Freedom amendment creates a fundamental constitutional right that Ohioans can use to defend themselves from invasive health care regulations, including the ppaca.

Passage of the ohio Health Care Freedom Amendment has the capacity to contribute to the invalidity of the Patient Protection and Affordable Care Act.
the mandate is less proper under the necessary and proper clause and the tenth amendment if it conflicts with state constitutional rights. separately, by creating a state constitutional right, passage of the amendment greatly enhances the likelihood that an individual rights claim against the ppaca minimum essential coverage mandate will succeed. it is acknowledged by opponents and proponents of the mandate alike that all health care and health insurance provisions of the ppaca collapse in the absence of a mandate.

Passage of the ohio Health Care Freedom Amendment assists the pending litigation challenging the constitutionality of the Patient Protection and Affordable Care act.
the amendments passage will allow for additional claims against the ppaca, and will assist current claims by casting further doubt on the legitimacy of the mandate, as against principles of federalism and enumerated powers.

Passage of the ohio Health Care Freedom Amendment necessarily provides protections that will be effective as against state and local government.
this means that Ohio and its local governments would be prohibited from enacting health care and health insurance mandates, a single-payer system, or any regulatory provisions equivalent to health care systems in massachusetts, vermont, canada, or the united Kingdom. moreover, even in the face of a valid federal health insurance mandate, Ohio governments would be prohibited from enacting regulations above and beyond the federal baseline. Finally, the amendment prohibits Ohio state and local governments from enacting any regulation that has the effect of significantly impeding health care or health care insurance choices, or significantly raising costs of health care or health care insurance.

Passage of the ohio Health Care Freedom Amendment could be influenced by outcomes in pending litigation challenging the constitutionality of the Patient Protection and Affordable Care act.
if the mandate, or entire bill, is found unconstitutional, the Ohio health care Freedom amendment, upon passage, would be viable in all respects. if the mandate is found to be a valid exercise of the commerce clause, necessary and proper clause, or taxing power, litigation will ensue under the Ohio health care Freedom amendment to determine whether Ohioans have a fundamental right to be free from the strictures of health care mandates. important protections in the Ohio health care Freedom amendment, other than those related to the mandating of health insurance are not affected by current ppaca litigation.

This is document is not intended to be an exhaustive legal argument. Requests for greater detail should be directed to Maurice A. Thompson, Director of the 1851 Center for Constitutional Law, at (614) 340-9817 or MThompson@OhioConstitution.org.

obamacare
Cancer survival rates in Canada and in europe are lower than in the U.S.
Why is this?
some argue it is because countries like the uK and canada have governmentrun health care that allows bureaucrats rather than doctors and patients make decisions about what kind of care people can receive and when they will get it.

women

and

obamacare
Q: Does Obamacare penalize couples for being married? A: Yes. heres an example...
UnmArried CoUple
Each person earns: $25,000 Total income: $50,000 Annual health insurance premium cap: $3,076

FAMILIES
mArried CoUple
Each person earns: $25,000 Total income: $50,000 Annual health insurance premium cap: $5,160

and

denial of preventive coverage


Obamacare requires insurers to cover all preventive measures ranked a or b by the u.s. preventive services task Force without costsharing.1 as of 2009, the rating of mammography for women ages 40-50 is c 2 and did not have to be covered by insurers until congress intervened. 3 how many more womens health services will fall victim to the task Force without being saved by congress?

How is your money being spent?


$50 million each year to school-based health centers, which may offer contraception or abortion services 3 $250,000 per state for a new personal responsibility education program required to teach contraception 4

denial of life-extending medication


in 2010, the Fda decided to de-label the life-extending, but expensive, cancer drug avastin because it has been deemed inefficient due to its high cost following denial of drug by britains national health agency. 4 this means more than 17,500 women must foot the $88,000/year bill on their own to stay alive. 5

exAmple mArriAge penAltY: $2,0841

did YoU knoW? c a n c e r


Women in U.S.
100

s u r v i va l r at e s

Penalties can be as high as $10,000 and hit young couples and empty nesters especially hard. 2

80

90% 79%

United States v. europe


82% 78% 63%

did YoU knoW? O b a m a c a r e


How does tHAt work?

d i s c r i m i n at e s against hiring lOW-incOme breadWinners.

there are some restrictions requiring these clinics to honor parental consent and notification laws, existing law already grants confidentiality privileges to teens, nullifying state and local policies. 5

We are working to preserve the sanctity of the doctor-patient relationship in the u.s. so that the government cant tell you what treatment you are allowed to have.

61% Women in Canada

60

56%

according to section 4980h (a)(1) of the patient protection and affordable care act, employers with more than 50 employees whose workers are eligible for and choose to take health care subsidies from the government are penalized.

40

20

58%

wHAt does tHis meAn?


breast uterine all cancer
theres an incentive to hire a teenager over a single mom or someone looking to supplement family income rather than a low-income breadwinner.
1. Martin Vaughan, Married Couples Pay More Than Unmarried Under Health Bill, Wall Street Journal, January 6, 2010,http://online.wsj.com/article/SB126281943134818675.html 2. Robert Rector, The New Federal Wedding Tax: How Obamacare Would Dramatically Penalize Marriage, Heritage Foundation, WebMemo, January 20, 2010, http://www.heritage.org/Research/Reports/2010/01/ The-New-Federal-Wedding-Tax- How-Obamacare-Would-Dramatically-Penalize-Marriage 3. Patient Protection and Affordable Care Act of 2010. 111th Cong., 2nd sess. Print 111-1. Washington: GPO, 2010. Print. [Sec. 4101] 4. Patient Protection and Affordable Care Act of 2010. 111th Cong., 2nd sess. Print 111-1. Washington: GPO, 2010. Print. [Sec. 513] 5. Parental Consent and Notice for Contraceptives Threatens (sic) Teen Health and Constitutional Rights. Center for Reproductive Rights. N.p., 01 Nov 2006. Web. 17 May 2011.(April 12, 2010).

1. Patient Protection and Affordable Care Act of 2010. 111th Cong., 2nd sess. Print 111-1. Washington: GPO, 2010. Print. [Sec. 4104 (b)(4)] 2. Screening for Breast Cancer, Topic Page. July 2010. U.S. Preventive Services Task Force. http://www.uspreventiveservicestaskforce.org/uspstf/uspsbrca.htm 3. Herszenhorn, David. Senate Blocks Use of New Mammogram Guidelines. Prescriptions. New York Times, 3 Dec 2009. Web. 16 May 2011. 4. Murch, Garrett. And So Rationing Begins: ObamaCare vs. Breast Cancer Patients. Townhall.com. N.p., 26 Feb 2011. Web. 16 May 2011. 5. Turner, Grace-Marie. Obamacare Assaults Medical Progress. Richmond Times-Dispatch 20 Mar 2011, Print. 6. Coleman, FFPH, Michel et al. Cancer survival in five continents: a worldwide population-based study. Lancet Oncology. 9.8 (2008): 730-756. Print.

obamacare
And its the only complaint Ive heard which is right, and that is the insurance companies are complaining that were going to cut Medicare. And theyre right.7
rep. John dingell (d-mi) march 21, 2010

seniors
taken from Medicare to pay for Obamacare1 payment cut for Medicare providers2 seniors will lose their retiree drug coverage3 of Medicare Part A providers will be unprofitable in 10 years4

and

obamacare
what if i...

DOCTORS

and

$575 Billion 30% 7.5 million 15%


did YoU knoW?

...dont report data on quality measures for covered professional services to HHs 1.5% reimbursement penalty starting in 2015, and 2.0% penalty starting in 20161 ...spend more than the government approves on a patient? Another reimbursement penalty2 ...dont implement new mechanisms created by the Act to improve quality? Cannot contract with any qualified health insurance plan Americans will be required to have3

tHe CoMinG SPeCiAliSt SHoRtAGe


Effective July 1, 2011, the Secretary must redistribute certain previously unfilled residency positions and direct those slots for training of primary care physicians. This means it will be harder for new doctors to become specialists, leaving the U.S. with a shortage as more specialists are choosing to retire early because of the burdens of Obamacare.1

obamacare created a new 3.8% Medicare tax imposed on unearned or investment income.
this tax, effective 2013, will hurt seniors who rely on investment income to cover living expenses.5 tHeY SAY: Obamacare will close the doughnut hole. BUt: it will do so at the price raising every seniors part d premium.
According to the Congressional Budget Office, Obamacare will cause seniors Part D premiums to increase 4% in 2011, rising up to 9% in 2019.6
1. McCaughey, Betsy. Medicare As Weve Known It Isnt an Option: Paul Ryans premium support plan is preferable to Obamas rationing panel. Wall Street Journal 27 Apr 2011: Opinion. Print. 2. Curry, Tom. Medicare Fund to Run out Five Years Earlier Than Projected. First Read. NBC, 13 May 2011. Web. 18 May 2011. 3. Jacobs, Chris. One Year Later: Obamacare STILL Bad for Seniors. Republican Policy Committee Blog. U.S. Senate Republicans, 22 Mar 2011. Web. 18 May 2011. 4. Ibid. 5. Katzeff, Paul. Two More Years Of Handling Benefits Of The Bush Tax Rates. Investors Business Daily 04 Apr 2011, OnlinePrint. 6. Comparison of Projected Medicare Part D Premiums Under Current Law and Under Reconciliation Legislation Combined with H.R. 3590 as Passed by the Senate. Congressional Budget Office. Congressional Budget Office, 19 Mar 2010. Web. 18 May 2011. 7. Dingell, John. Press Conference. U.S. House of Representatives. Washington, D.C.. 22 Mar 2010. Address.

thanks to the patient protection and affordable care act, medicare reimbursement rates are slated to decrease 29.5% in 2012.
Table 1. Current Estimates of SGRs for CY 2010, CY 2011, and CY 2012 4
Factor 1: Increase in Fees Factor 2: Increase in Enrollment Factor 3: Increase in 10-year moving average Real Per Capita GDP Factor 4: Increase due to changes in Law or Regulations Total Sustainable Growth Rate CY 2010 0.9% 1.1% 0.7% 5.7% 8.6% CY 2011 0.2% 3.0% 0.8% 2.9% 7.0% CY 2012 0.1% 3.3% 0.9% 20.6% 17.2%

1. Patient Protection and Affordable Care Act of 2010. 111th Cong., 2nd sess. Print 111-1. Washington: GPO, 2010. Print. [Sec. 3002(b)(8)] 2. Gray, M.D., C.L. Obamacare Rips Doctor-Patient Relationship Apart. Fox Newx 25 Mar 2010: n. pag. Web. 16 May 2011. <http://www.foxnews.com/opinion/2010/03/25/clgray-health-care-obamacare-physicians-hippocrates-medicare-plato/#ixzz1JQR0rjOU>. 3. Patient Protection and Affordable Care Act of 2010. 111th Cong., 2nd sess. Print 111-1. Washington: GPO, 2010. Print. [Sec. 1311(h)(1)(B)] 4. United States. Estimated Sustainable Growth Rate and Conversion Factor, for Medicare Payments to Physicians in 2012. , 2011. Web. 18 May 2011. <https://www.cms.gov/SustainableGRatesConFact/Downloads/sgr2012p.pdf>.

1. Reizen, Myla, and Neely Griffith. Summary of Health Care Reform Changes. Jones Walker e*bulletin 3. (2010): 2. Web. 16 May 2011. <http://www.martindale.com/members/Article_Atachment.aspx?od=2919 60&id=1052958&filename=asr-1052998.pdf>.

obamacare
Can i be fined if my employees spouse loses his or her job?
$1
Yes. Lets say Jane works for you and is married to Dick, who works for Acme Widgets. Dick gets laid off, meaning that Jane has incurred a loss in houshold income that makes your insurance plan unaffordable under the new law. Youre going to be stuck paying a $3000 penalty.

BUSINESS
-per-life tax on policies to fund research tax on investments tax on individual plans over $10,200 employees to invoke employer mandate penalty per full-time employee not insured in penalties projected over ten years
b u s i n e s s ta x c r e d i t
2. OhF is registered as a ballot issue political action committee under Ohio campaign finance laws. 3. OhF may accept unlimited contributions from any source, including individuals, corporations, and trade associations, but does not accept contributions from foreign nationals. 4. contributor information (name, address, employer, and the amount contributed) is required to be publicly disclosed on OhFs campaign finance reports. For activity in 2011, OhF will file campaign finance reports on:
July 29, 2011 (disclosing all contributions from January 1, 2011 through June 30, 2011) August 6, 2011 (disclosing all contributions used for petition circulation) October 27, 2011 (disclosing all contributions from July 1, 2011 through October 19, 2011) December 16, 2011 (disclosing all contributions from October 20, 2011 through december 9, 2011) January 31, 2012 (disclosing all contributions from december 10, 2011 through december 31, 2011)

and

disclosure Statement
1. Ohioans for healthcare Freedom (OhF) is an Ohio nonprofit corporation which is exempt from federal taxation under section 501(c)(4) of the internal revenue code.

3.8% 40% 50 $2000 $52 billion

did YoU knoW? s m a l l

Can i be fined if i offer health insurance, and my employee decides not to enroll?
Yes. If you offer your employee, Jane, a health insurance plan and her household income is less than 400% of poverty ($88,199 for a family of four), she may be able to choose a subsidized exchange plan instead, resulting in a $3000 penalty for you.

the self-employed represent 78% of all small businesses in the united states, but dont qualify.

78%

WhO qualiFies FOr Full credit? 10 or fewer employees

5. the irs does not allow contributions to OhF to be deducted as a charitable contribution or as a business expense. contributions may be subject to federal gift tax laws. please consult with your tax advisor for more details. prepared by:

Average taxable wage <$25,000 Pay 50% of the cost of coverage

David R. Langdon, Esq. langdon law llc 11175 reading rd., ste. 104 cincinnati, Oh 45241

J. Matthew Yuskewich, CPA Winterset cpa group, inc. 4679 Winterset drive columbus, Oh 43220

BEginning in 2014, ThE CrEDiT is Only AvAilABlE fOr tWo YeARS


Source: White, Joel et al. Critical Employer Issues in the Patient Protection and Affordable Care Act. Washington, D.C.: U.S. Chamber of Commerce, 2011. Print. IRS Circular 230 Disclosure. To ensure compliance with requirements imposed by the IRS, any U.S. federal tax advice contained in this document is not intended or written to be used, and cannot be used, for the purpose of (i) avoiding penalties under the Internal Revenue Code, or (ii) promoting, marketing, or recommending to another party any transaction or matter that is contained in this document.

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Join our team to


PrOtect YOur HeAltHcAre.
Preserve ohioans Freedom.

Get InvOlved tOdAY.


Now more than ever, we need your help to fight Obamacare. Contact Ohioans for Healthcare Freedom to learn more about how you can help.

Ohioans for Healthcare Freedom, Inc. Jeff Longstreth 145 E. Rich St., Suite 101 Columbus, OH 43215 (614) 378-1107 JeffLongstreth@gmail.com www.OhioansForHealthcareFreedom.com

Paid for by Ohioans for Healthcare Freedom J. Matthew Yuskewich, Treasurer 4679 Winterset Drive Columbus, OH 43220