The lopsided vote in favor of Proposition C in Missouri last month - we were told - sent a message that Missouri rejects national health care reform.

But wait. What if the feds, as part of the health care reform bill, are willing to shore up health coverage for millions of early retirees?

In that case, Missouri loves health care reform.

Last week, the federal government released a list of 2,000 corporations, unions and government entities that have asked to participate in a $5 billion reinsurance program created under the federal health care reform law.

Among them: the state of Missouri, where 71 percent of voters in the low-turnout Aug. 3 primary voted to reject the federal law's mandate that individuals buy health insurance.

"The citizens of the Show-Me State don't want Washington involved in their health care decisions," said Sen. Jane Cunningham, R-Chesterfield, at an election-night victory party.

On the other hand, if the feds are willing to underwrite health care benefits for state retirees, that's a different matter.

 

Governments in seven states that filed suit to block health care reform have applied for the reinsurance program: Arizona, Idaho, Indiana, Louisiana, Michigan, Nebraska and Nevada. Call it the conspiracy of hypocrites.

Missouri is a special case. Lt. Gov. Peter Kinder filed suit to block federal health reform, but as a private citizen, not as a representative of the state.

The states have lined up for a simple reason: The reinsurance program could protect health care benefits for thousands of people who retired too young to qualify for Medicare.

That group includes many police officers and firefighters. Often, they qualify for retirement after serving as little as 20 years.

Under the reinsurance program, the federal government will pick up 80 percent of health costs for retirees with medical claims between $15,000 and $90,000.

Not many people run up medical bills that high. But it just takes a few claims that large to drive premiums through the roof for companies - and governments - that provide health care benefits for retired workers.

When that happens, especially in tough economic times, companies often drop coverage, leaving early retirees to fend for themselves.

That can have disastrous consequences because health insurance can be prohibitively expensive for people buying it on their own after age 50. For those with existing health problems, it can be impossible to buy at any price.

 

Missouri companies Anheuser-Busch InBev, Arch Coal, Hallmark Cards, Great Plains Energy, Laclede Gas, MFA Energy, Patriot Coal, Solutia and Olin Corp. also are on the list.

So is the Missouri Consolidated Health Plan, which provides benefits to current and retired state workers. So are many local governments and school districts. The situation is the same in Illinois, with private companies and state and local governments lining up.

In all of the overheated rhetoric that accompanied the health care debate, we rarely heard mention of the reinsurance program, the high-risk health insurance pools being set up in each state or curbs on insurance company abuses and coverage exclusions for pre-existing conditions. Yet those are major parts of health care reform.

So here's the real lesson from Proposition C vote: Like residents of Illinois, Iowa and every other state, Missourians don't want federal health care reform. We want just the parts that benefit us. Which, when you look closely at the reform law, is pretty much all of it.