Voters in Ohio have approved a ballot measure intended to keep government from requiring Ohioans to participate in any health care system.
The constitutional amendment passed is largely symbolic, coming in response to the 2009 federal health care overhaul, a provision of which mandates that most Americans purchase health care.
Supporters hope it will prompt a challenge of the overhaul before the U.S. Supreme Court.
The tea party and Republican groups backing the amendment say the Affordable Care Act was an overreach by the Obama administration and Congress.
They hope approval of the ballot issue will bar Ohio from instituting a state-mandated health insurance program like that of Massachusetts.
Opponents argued state law can't trump federal law and that the amendment's wording could unintentionally jeopardize state health programs.