Voters in Missouri Oppose Health Law

Missouri voters on Tuesday overwhelmingly approved a measure intended to nullify the new federal health care law, becoming the first state in the nation where ordinary people made known their dismay over the issue at the ballot box.

The measure was meant to invalidate a crucial element of President Obama’s health care law — namely, that most people be required to get health insurance or pay a tax penalty. Supporters of the measure said it would send a firm signal to Washington about how this state, often a bellwether in presidential elections, felt.

The referendum drew support from 71 percent of nearly 939,000 voters. “My constituents told me they felt like their voices had been ignored and they wanted Washington to hear them,” said Jane Cunningham, a state senator and Republican. “It looks to me like they just picked up a megaphone.”

The referendum, known as Proposition C, was seen as a first look at efforts by conservatives to gather and rally their forces over the issue. Practically speaking, it remains entirely uncertain what effect the vote will have. The insurance requirement of the federal health care law does not come into effect until 2014. By then, experts say, the courts are likely to weigh in on the provision.

Primaries around the Midwest set the cast for political battles in November. In Michigan, where Gov. Jennifer M. Granholm, a Democrat, is barred by term limits from seeking re-election, Rick Snyder, a businessman who has never held office, defeated four other Republicans, including the state attorney general and a United States representative.

Virg Bernero, the mayor of Lansing, won on the Democratic side.

In a closely watched Congressional race, Carolyn Cheeks Kilpatrick, a seven-term representative, was defeated by Hansen Clarke, a state senator, in a Democratic primary for her seat. Ms. Kilpatrick’s son, Kwame M. Kilpatrick, the disgraced former mayor of Detroit, is in jail on a probation violation and is awaiting trial on federal charges of tax evasion and mail and tax fraud.

In Kansas, a bitter, personal Republican primary battle for the United States Senate ended with Representative Jerry Moran beating Representative Todd Tiahrt. Much of the campaign seemed to center on which man — Mr. Tiahrt (who boasted Sarah Palin’s support) or Mr. Moran (who campaigned this week with Senator Tom Coburn of Oklahoma) — had true rights to the conservative title.

Either one had been widely expected to win in November. Kansas has not sent a Democrat to the Senate in more than 70 years.

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