So far, the notion has been presented in at least 10 states (though it has already been rejected or left behind in committees in some of them), and lawmakers in four other states have said they will soon offer similar measures in what has grown into a coordinated effort at resistance. (Arizona, which has placed the amendment on its ballot in 2010, seems the furthest along.)

Here in Minnesota, as in many of the other states, the move to amend the State Constitution is being driven by a handful of Republican lawmakers. The proposed amendment itself does not advocate some particular alternative plan, but sets what its authors see as ground rules for what any future health care system should  and should not  include.

“All I’m trying to do is protect the individual’s right to make health care decisions,” said State Representative Tom Emmer, a Republican. “I just don’t want the government getting between my decisions with my doctors.”

Many who favor a federal overhaul of health care say it can be affordable only if nearly everyone is required to carry insurance, but the efforts by these state lawmakers actually predate the Obama administration and the current federal health care debate.

Proposed constitutional amendments began cropping up after 2006, when Massachusetts enacted a sweeping state measure meant to create nearly universal health coverage for residents. Elsewhere, some leaders  opposed to the possibility of insurance mandates or government-run systems  began suggesting constitutional amendments to block such measures from their own states.