[JURIST] Ballot proposals to exempt residents from portions of the Patient Protection and Affordable Care Act (PPACA) [text; JURIST news archive] were approved Tuesday in Montana [Referendum No. 122, PDF], Alabama [Amendment 6, PDF; results] and Wyoming [Amendment A, PDF; results]. A similar amendment in Florida [Amendment 1, PDF; results] was narrowly defeated by voters. The PPACA was a comprehensive health care reform [JURIST backgrounder] law passed in March 2010. The amendments seek to exempt residents from the PPACA’s “individual mandate” provision [text], which requires every person, with some exceptions for religious and other reasons, to purchase some form of health insurance by January 1, 2014, or be subject to a fee equal to either a percent of that individual’s income or flat rate of $695. The measures are likely to be of only symbolic effect however, as the federal PPACA likely preempts state law.

Earlier this year, the US Supreme Court [official website] ruled [opinion, PDF; JURIST report] that the PPACA is constitutional, and that the individual mandate is a valid revenue-raising tax. The lawsuit [JURIST report] that was heard before the Supreme Court was brought by 26 states and additional organizations challenging both the individual mandate to purchase health insurance and Medicaid expansion included in the law. The ruling on the constitutionality of the act was highly anticipated by both politicians and the general public.