"On the House floor today, the Republicans focused on attacking the individual mandate. Just like they did yesterday in the amendments they offered to the Rules Committee. Just as John Boehner relentlessly did this week on Meet the Press.

Their rhetoric feeds into an extensive and well-funded network of right wing groups that stand ready to push anti-mandate ballot initiatives for 2010 that will go into overdrive upon passage of the health care bill:

GOP leaders hope at a minimum that they can energize conservative activists and turn the electorate against the Democrats in the crucial period after the law's enactment, when both parties would be fighting to define it in the public's mind before the November elections...Republicans also predict an instant movement to repeal the health measure should it pass. "It will be a spontaneous combustion throughout the country," said Sen. Lamar Alexander (R., Tenn.)

There are already twenty state constitutional amendments moving through legislatures that could wind up on the ballot in 2010 or 2012. While Steny Hoyer may be confident that the courts will rule that federal law trumps that of states, that won't affect the ability of Republicans to use the issue to spur voter turnout in 2010 -- the same purpose served by anti-gay marriage ballot measures in 2004 and 2006.

The effort has accelerated just in the past few weeks:

> On March 10, Virginia was the first state to pass a national healthcare nullification law -- through Democratic controlled legislature and Senate.

> On March 11, the Oklahoma House of Representatives passed their constitutional amendment, 77-10. It now heads to the Senate.

> On March, 16, the Missouri legislature approved their constitutional amendment, 109-46. It now heads to the Senate.

> On March 17, Idaho governor Butch Otter signed into law a measure requiring the state attorney general to file suit if the health care bill includes a mandate.

> Next Wednesday the Tennessee House will vote on their constitutional amendment, which has already passed the Senate, 21-1-5. The "5" were Democrats who chose to vote "present." Republican gubernatorial candidates Ron Ramsey and Zach Wamp are both backing it.

> Democratic legislators have also joined with Republicans to move the measure along in Iowa and West Virginia.

> In Alabama, Governor Reilly urged the Alabama delegation to vote "no" on the health care bill. All of the gubernatorial candidates are beings pressed about their positions.

> California's amendment also prohibits the creation of "a single-payer health care system, unless the program is approved by the electorate by ballot measure."

> A citizen-led effort for an amendment to the Colorado state constitution is now gathering signatures

> At the request of Richard Luger, Indiana Attorney General Greg Zoeller prepared a report and concluded that the bill would likely be found unconstitutional.

> The attorney generals of Florida, Virginia and South Carolina have said they will file suit arguing that the mandate is unconstitutional.

As Larry Sabato says, being able to vote for the measure helped Democratic legislators who are "somewhere between worried and panicked" about the fall election and looking to distance themselves from the bill.

Republicans across the country have been the recipients of big money from health care lobbyists: $102 million to state political campaigns in 2008. In Florida alone, they received $765,000 in 2008 according to the New York Times. Now those interests are pointing them at the anti-mandate efforts initially spearheaded by the Goldwater Institute of Arizona, and then picked up by the American Legislative Exchange Council (ALEC).

ALEC is "a business-friendly conservative group that coordinates activity among statehouses. Five of the 24 members of its 'free enterprise board' are executives of drug companies and its health care "task force" is overseen in part by a four-member panel composed of government-relations officials for the Blue Cross and Blue Shield Association of insurers, the medical company Johnson & Johnson and the drug makers Bayer and Hoffmann-La Roche."

While the red meat of the Arizona ballot measure is aimed at the mandate penalty, it also targets Medicaid obligations. Many of the state measures would also make it illegal for the states to adopt single payer systems.

In their infinite wisdom, Congress also allowed states to opt out of providing abortion coverage on the state exchange via ballot initiative, so many of these states may try for a two-fer. But the extensive infrastructure already in place to oppose the mandate is geared up and ready to go.

Of course, all of this would have been obviated if the White House had opted for their Plan B three weeks ago, which had no mandate, no exchanges or any need for abortion language (since it didn't create any new bureaucracy and simply expanded programs already covered by the Hyde amendment). But with the health care bill looking to pass with all the raw material the GOP could want to fuel its GOTV efforts in the fall, the Democratic party could be walking into a 2010 buzzsaw.

There actually will be one critical difference between the anti-mandate and the anti-gay marriage initiatives: there were actually passionate opponents of the anti-gay marriage efforts. There will not be any swell of grassroots support to oppose a fine that the IRS collects.

That ought to present an interesting challenge for Organizing for America."

By: Jane Hamsher