Here is the text of Proposition C:

Shall the Missouri Statutes be amended to:

• Deny the government authority to penalize citizens for refusing to purchase private health insurance or infringe upon the right to offer or accept direct payment for lawful healthcare services?
• Modify laws regarding the liquidation of certain domestic insurance companies?

It is estimated this proposal will have no immediate costs or savings to state or local governmental entities. However, because of the uncertain interaction of the proposal with implementation of the federal Patient Protection and Affordable Care Act, future costs to state governmental entities are unknown.

Does Missouri now claim the power to stop the feds from penalizing citizens for refusing to purchase health insurance? This seems more like an assertion of some reserved state right rather than nullifying PPACA. Is this like a modern day Kentucky and Virginia Resolutions, seeking to nullify a federal law? Not really sure.

Hmmm. Check out Randy Barnett’s post on nullification.

Update: Commenter Alan writes:

I guess if the Missouri AG was challenging the PPACA this law would give them standing to sue, like in Virginia?

Passing a statute to grant standing/get around tax injunction act? This seems to be exactly what Jack Balkin was talking about. Is this Kosher?

Update: The Constitutional Law Prof Blog answers some of these questions:

Missourians overwhelmingly voted to nullify the federal health insurance mandate by adopting state law, effective immediately, that allows Missourians not to purchase health insurance in violation of the federal mandate.

. . .

But Monday’s ruling in the Virginia case challenging the federal mandate suggests that the Missouri vote might be constitutionally relevant in one way: to establish state standing to challenge the federal mandate in court.  In Monday’s district court ruling denying the federal government’s motion to dismiss, the court ruled that Virginia had standing to challenge the federal mandate because Virginia sought to enforce its own nullification law, the Virginia Health Care Freedom Act.  Virginia seemed to have adopted this law for the sole purpose of establishing standing in its case against the federal government–and it worked.  Missouri, by contrast, passed its nullification law by referendum–a perhaps less obviously opportunistic way to pass a conflicting state law.  If Virginia’s Freedom Act is sufficient to establish standing, Missouri’s new nullification law is even more, should Missouri file a case.